Healthcare Provider Details

I. General information

NPI: 1356888440
Provider Name (Legal Business Name): FREDRIKA PAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 TIMBER DR E
GARNER NC
27529-6924
US

IV. Provider business mailing address

3001 EDWARDS MILL RD STE 200
RALEIGH NC
27612-5243
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-4060
  • Fax: 919-781-5246
Mailing address:
  • Phone: 919-781-4060
  • Fax: 919-781-5246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA3691
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: