Provider Demographics
NPI:1700460516
Name:FREY, JENNIFER MARIE (CNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:FREY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WYANDOT MEMORIAL HOSPITAL
Mailing Address - Street 2:885 N SANDUSKY AVE
Mailing Address - City:UPPER SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:43351-1098
Mailing Address - Country:US
Mailing Address - Phone:419-294-4991
Mailing Address - Fax:419-209-0278
Practice Address - Street 1:112 E LIMA ST
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:OH
Practice Address - Zip Code:45843-1116
Practice Address - Country:US
Practice Address - Phone:419-731-5104
Practice Address - Fax:419-731-5106
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028663363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily