Healthcare Provider Details

I. General information

NPI: 1104042555
Provider Name (Legal Business Name): CYNTHIA FREY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1899 BILLINGSGATE CIR STE A
HENRICO VA
23238-4243
US

IV. Provider business mailing address

9702 GAYTON RD STE 219
HENRICO VA
23238-4907
US

V. Phone/Fax

Practice location:
  • Phone: 804-928-5830
  • Fax: 804-509-2403
Mailing address:
  • Phone: 804-938-9898
  • Fax: 804-509-2403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number2006011232
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024097886
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: