Provider Demographics
NPI:1477219137
Name:FRY, RACHEL AMANDA (PA-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:AMANDA
Last Name:FRY
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 14417
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-1417
Mailing Address - Country:US
Mailing Address - Phone:912-721-5167
Mailing Address - Fax:912-721-7886
Practice Address - Street 1:1394 W 16TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-4430
Practice Address - Country:US
Practice Address - Phone:928-539-0055
Practice Address - Fax:928-539-0053
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2025-09-12
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Provider Licenses
StateLicense IDTaxonomies
AZ11021363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant