Provider Demographics
NPI:1780940197
Name:FREGO, JENNIFER HARRISON (CRNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:HARRISON
Last Name:FREGO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 CENTER ST
Mailing Address - Street 2:DIVISION OF NEONATOLOGY
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-3301
Mailing Address - Country:US
Mailing Address - Phone:251-415-1270
Mailing Address - Fax:251-415-1049
Practice Address - Street 1:1700 CENTER ST
Practice Address - Street 2:DIVISION OF NEONATOLOGY
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-3301
Practice Address - Country:US
Practice Address - Phone:251-415-1270
Practice Address - Fax:251-415-1049
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-090676363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care