Provider Demographics
NPI:1942036421
Name:FREY, KATHERINE (CBS)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:FREY
Suffix:
Gender:F
Credentials:CBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HATCHER DR
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72715-1693
Mailing Address - Country:US
Mailing Address - Phone:620-388-4536
Mailing Address - Fax:
Practice Address - Street 1:17 HATCHER DR
Practice Address - Street 2:
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72715-1693
Practice Address - Country:US
Practice Address - Phone:620-388-4536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN