Provider Demographics
NPI:1528115714
Name:FREGULIA, CHRISTINE A (NP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:FREGULIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2200
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423
Mailing Address - Country:US
Mailing Address - Phone:775-782-4800
Mailing Address - Fax:775-782-4811
Practice Address - Street 1:1664 US HIGHWAY 395 N
Practice Address - Street 2:SUITE 201
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423
Practice Address - Country:US
Practice Address - Phone:775-782-4800
Practice Address - Fax:775-782-4811
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV37474363L00000X
NVAPN00304363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002416033Medicaid
NV0007798508OtherAETNA PIN
NV0007798508OtherAETNA PIN
NVS46501Medicare UPIN
37474Medicare ID - Type Unspecified
NV002416033Medicaid