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NPI Code Detail

MEDICARE: JENNIFER LYNN FREY

MEDICARE: JENNIFER LYNN FREY
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
1363L00000XNurse Practitioner4704300379MI
2163WH0200XHome Health Registered Nurse4704300379MI

General Provider Information

NPI Number : 1437667946
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYNN FREY
Provider Business Mailing Address
First Line : PO BOX 320008
Second Line :
City : FLINT
State : MI
Zip : 48532-0001
Country : US
Telephone Number : 517-349-3303
Fax Number : 517-349-0828
Provider Business Practice Location Address
First Line : 5758 COOLEY LAKE RD
Second Line :
City : WATERFORD
State : MI
Zip : 48327-3073
Country : US
Telephone Number : 855-466-3631
Fax Number : 833-973-4493
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2018
Last Update Date : 03/23/2026

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