Provider Demographics
NPI:1184269649
Name:FREI, DAVINA LAMAR (DNP, AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:DAVINA
Middle Name:LAMAR
Last Name:FREI
Suffix:
Gender:F
Credentials:DNP, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 N FEDERAL HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4618
Mailing Address - Country:US
Mailing Address - Phone:305-974-5533
Mailing Address - Fax:
Practice Address - Street 1:4801 N FEDERAL HWY STE 200
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4618
Practice Address - Country:US
Practice Address - Phone:305-974-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-08
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004997363LA2100X
FLAPRN11004997363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care