MEDICARE: JENNIFER LYNN FRALEY M.D.

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	207V00000X	Obstetrics & Gynecology Physician	A114863	CA
2	207V00000X	Obstetrics & Gynecology Physician	MD451300	PA
3	207V00000X	Obstetrics & Gynecology Physician	222762	NC

General Provider Information

NPI Number	:	1306019195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNN FRALEY M.D.

Provider Business Mailing Address
First Line	:	550 NEW WAVERLY PLACE
Second Line	:	SUITE 200
City	:	CARY
State	:	NC
Zip	:	27518
Country	:	US
Telephone Number	:	919-467-5941
Fax Number	:	919-277-2043

Provider Business Practice Location Address
First Line	:	550 NEW WAVERLY PL STE 200
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27518-7412
Country	:	US
Telephone Number	:	919-467-5941
Fax Number	:	919-277-2043

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

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	07/21/2022

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