Healthcare Provider Details

I. General information

NPI: 1417447665
Provider Name (Legal Business Name): JENNA FREITAS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2018
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CFV VILLAGE SURGICAL 1841 QUIET COVE
FAYETTEVILLE NC
28304-3424
US

IV. Provider business mailing address

1638 OWEN DR
FAYETTEVILLE NC
28304-3424
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-2626
  • Fax: 910-484-7962
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2023-01996
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: