Provider Demographics
NPI:1508164260
Name:FREY, MARIE M (FNP)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:M
Last Name:FREY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 AVERY ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-3739
Mailing Address - Country:US
Mailing Address - Phone:252-247-4297
Mailing Address - Fax:252-247-7383
Practice Address - Street 1:3031 NEW BERN AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-2988
Practice Address - Country:US
Practice Address - Phone:919-231-3966
Practice Address - Fax:919-231-3912
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC171918363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1508164260OtherNPI