MEDICARE: WINTANA FRAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	R211349	MD

General Provider Information

NPI Number	:	1225903578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WINTANA FRAY

Provider Business Mailing Address
First Line	:	1817 STALEY MANOR DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1564
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1817 STALEY MANOR DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1564
Country	:	US
Telephone Number	:	240-478-9240
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2025
Last Update Date	:	10/07/2025

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Directions to “ WINTANA FRAY ” Practice Location

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