Provider Demographics
NPI:1679954739
Name:FRYE, TOSHA
Entity type:Individual
Prefix:
First Name:TOSHA
Middle Name:
Last Name:FRYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TOSHA
Other - Middle Name:
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2727 W 92ND AVE
Mailing Address - Street 2:SUITE 100D
Mailing Address - City:FEDERAL HEIGHTS
Mailing Address - State:CO
Mailing Address - Zip Code:80260-5221
Mailing Address - Country:US
Mailing Address - Phone:303-482-1339
Mailing Address - Fax:
Practice Address - Street 1:2727 W 92ND AVE
Practice Address - Street 2:SUITE 100D
Practice Address - City:FEDERAL HEIGHTS
Practice Address - State:CO
Practice Address - Zip Code:80260-5221
Practice Address - Country:US
Practice Address - Phone:303-482-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO49050737Medicaid