Susan Marilyn Frye, RN, PHN, GNP,C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

399028 Issued in CA

Practice address

3440 Hollywood Blvd
Suite 460
Hollywood, FL 33021-6927

Phone

(866) 986-2263

Fax

(866) 968-6339

NPI assigned

Jun 14, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Susan Marilyn Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1811930894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3583 GRANADA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921044144",
            "telephone_number": "619-688-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 HOLLYWOOD BLVD",
            "address_2": "SUITE 460",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216927",
            "telephone_number": "866-986-2263",
            "fax_number": "866-968-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYE",
        "first_name": "SUSAN",
        "middle_name": "MARILYN",
        "name_prefix": "Ms.",
        "credential": "RN, PHN, GNP,C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "399028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "JOHNSON",
            "middle_name": "MARILYN",
            "prefix": "MS.",
            "credential": "RN,  PHN, GNP,C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Friedman
• Jonathan Friedman
• Judith A. Friedman, PH.D., LCSW
• Lisbet Frometa Socarras
• Leonardo Frydman, D.M.D.
• Rachel Vanessa Ftaiha, LMHC, LMFT, LPC
• Yanirys Fuente-Espinoza
• Hernan G Fuentes Figueroa, MD
• Full Time Human LLC
• Alesia Fuller, CBHT

• Gerontology Nurse Practitioner in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.