Healthcare Provider Details

I. General information

NPI: 1700579349
Provider Name (Legal Business Name): ZOE FRALEY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 05/30/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 AMHERST ST
WINCHESTER VA
22601-2808
US

IV. Provider business mailing address

11 CHILLINGHAM CT
MARTINSBURG WV
25405-5754
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-8000
  • Fax:
Mailing address:
  • Phone: 304-851-1973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0024187169
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: