Nikki Lynn Frey, CNP
Individual provider Active NPI Gerontology Nurse Practitioner · Upper Sandusky, OH
NPI 1730722901 · NPPES record last updated Oct 21, 2019
Key facts
- NPI
- 1730722901
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- APRN.CNP.025848 (OH)
- Practice address
- 105 Houpt Dr
Upper Sandusky, OH 43351-9201 - Phone
- (419) 294-5787
- NPI assigned
- Oct 21, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Opted out of Medicare
- Yes, effective Oct 1, 2026 through Oct 1, 2028
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210719000384 | OH | Practitioner - Nurse Practitioner | 8729480496 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wyandot Memorial Hospital | Current |
Accepting new patients | |
| Wyandot Memorial Hospital | Current |
Accepting new patients |
Locations
885 N Sandusky Ave
Upper Sandusky, OH 43351
Phone (419) 294-4991
105 Houpt Dr
Upper Sandusky, OH 43351
Phone (419) 294-5787
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | APRN.CNP.025848 | OH | Yes |
Addresses
Primary practice location
105 Houpt Dr
Upper Sandusky, OH 43351-9201
Mailing address
105 Houpt Dr
Upper Sandusky, OH 43351-9201
Phone (419) 294-5787
Other names
- Nikki Lynn Lanagan
Other providers in Upper Sandusky, OH
- Fountain Park Inn, Upper Sandusky
- Freedom Caregivers, Inc.
- Freedom Healthcare LLC
- Freedom Medical Supply Inc.
- Natalie Frey
- Olivia Frey
- Morgan Gault
- Scott M Gier
- Aleisha Gilmore
- Jessica A. Gilmore
All providers in Upper Sandusky, OH · Gerontology Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.