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General NPI Number Information
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NPI Number | 1851514806
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Entity Type | Individual
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Provider Name | NANCY-LU FRIESE MOUL C.F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | ONE GOOCH DRIVE
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City | WILLIAMSBURG
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State | VA
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Zip | 23187
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Country | US
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Telephone | 757-221-2246
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Fax |
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Provider Business Mailing Address
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Address Line | 105 SIXPENCE CT
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-4923
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Country | US
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Telephone | 757-220-1935
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024070729
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License Number State | VA
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