Provider Demographics
NPI:1558872150
Name:FREY, ANNETTE (RN)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:FREY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2433 HUNTINGDON PIKE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6111
Mailing Address - Country:US
Mailing Address - Phone:215-245-2131
Mailing Address - Fax:215-245-3484
Practice Address - Street 1:5500 TABOR AVE STE 301
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-2124
Practice Address - Country:US
Practice Address - Phone:215-245-2131
Practice Address - Fax:215-245-3484
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN520857L163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health