Basic Information
| Provider Information | |||||||||
| NPI: | 1316317498 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FREY | ||||||||
| FirstName: | PAIGE | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16040 ROAD M | ||||||||
| Address2: | |||||||||
| City: | OTTAWA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458758409 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1740 N PERRY ST | ||||||||
| Address2: | |||||||||
| City: | OTTAWA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458751173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195230012 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2015 | ||||||||
| LastUpdateDate: | 10/01/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | COA.18203-NP | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.