NPI Code Detail JSON Logo

1265093074 NPI number — NEIL JOHNATHON FREY APRN

NPI Number: 1265093074
Health Care Provider/Practitioner: NEIL JOHNATHON FREY APRN

Information about “1265093074” NPI (NEIL JOHNATHON FREY APRN) exists in 1265093074 in HTML format HTML  |  1265093074 in plain Text format TXT  |  1265093074 in PDF (Portable Document Format) PDF  |  1265093074 in an XML format XML  formats.

NPI Number : 1265093074 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265093074",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FREY",
    "FirstName": "NEIL",
    "MiddleName": "JOHNATHON",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APRN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "341 ALLISON DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PALM BAY",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32908-6405",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "321-282-1499",
    "MailingAddressFaxNumber": "321-256-6212",
    "FirstLinePracticeLocationAddress": "341 ALLISON DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PALM BAY",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32908-6405",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "321-543-9830",
    "PracticeLocationAddressFaxNumber": "321-256-6212",
    "EnumerationDate": "06/23/2019",
    "LastUpdateDate": "01/30/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "APRN11002739",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LG0600X",
          "TaxonomyName": "Gerontology Nurse Practitioner",
          "LicenseNumber": "APRN11002739",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.