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General NPI Number Information
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NPI Number | 1063080174
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Entity Type | Individual
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Provider Name | DAVID CHARLES FREY DNP, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | USNMRTU IWAKUNI, BLDG 110, MCAS IWAKUNI 1 MISUMI MACHI
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City | IWAKUNI
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State | YAMAGUCHI
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Zip | 7400025
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Country | JP
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Telephone | 315-255-8331
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 561 BOX 1877
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City | FPO
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State | AP
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Zip | 96310-0014
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Country | US
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Telephone | 619-632-5919
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024187590
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License Number State | VA
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