Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kellye Fryar, FNP

Individual provider Family Nurse Practitioner · NPI 1063157857

Kellye Fryar, FNP is a Nurse Practitioner in Cleveland, Tennessee. Qualified in 2021, 5 years ago. Practices with Legacy Healthcare Services Inc, a 3,624-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
5
Licensed in
TN
In the registry since
2022
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

463 1st St NW
Cleveland, TN 37311-1760
Phone: (423) 790-7662
Fax: (423) 790-7664
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 31553 (TN)

Record details

NPI number1063157857
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorYes
NPI enumeratedMay 5, 2022
Last updated in NPPESMay 5, 2022
Certification dateMay 4, 2022
Mailing address4662 E Circle Dr Nw, Cleveland, TN 37312-4101

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Legacy Healthcare Services Inc — 3624 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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