Active NPI
Nancy J Fredo, CNM
- Advanced Practice Midwife
- Nacogdoches, TX
National Provider Identifier
1861554818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 599046
- Practice address
- 1108 South St
Nacogdoches, TX 75964-5986 - Phone
- (936) 560-3097
- Fax
- (936) 462-8080
- NPI assigned
- Dec 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 599046 | TX | Primary |
Addresses
Primary practice location
1108 South St
Nacogdoches, TX 75964-5986
Mailing address
PO Box 3488
Tupelo, MS 38803-3488
Phone (936) 568-8425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5869 | TX | MD | Chiropractor |
| 599046 | TX | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562630400000",
"number": "1861554818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3488",
"city": "TUPELO",
"state": "MS",
"postal_code": "388033488",
"telephone_number": "936-568-8425",
"fax_number": "936-568-8570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 SOUTH ST",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759645986",
"telephone_number": "936-560-3097",
"fax_number": "936-462-8080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDO",
"first_name": "NANCY",
"middle_name": "J",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-15",
"last_updated": "2019-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "TX",
"license": "599046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nacogdoches, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.