Healthcare Provider Details

I. General information

NPI: 1619173176
Provider Name (Legal Business Name): JENNIFER A FREY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 S GOVERNORS AVE
DOVER DE
19904-3523
US

IV. Provider business mailing address

640 S STATE ST MAIL CODE 3055
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-310-8484
  • Fax: 302-672-4606
Mailing address:
  • Phone: 302-310-8484
  • Fax: 302-672-4606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG0000391
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: