Most Relevant Information
Provider Data
| NPI Number: | 1003646795 |
| Provider Name: | EBITARI 0 FREGENE DNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 2024031047 |
Most Important Dates
| Enumeration Date: | 08/06/2024 |
| Last Updated: | 08/06/2024 |
Provider Practice Location
115 GOLDEN GATE PKWY
WENTZVILLE
MO
633857288
Practice Location Phone/Fax
| Phone: | 3143977219 |
| Fax: |
Provider Mailing Location
115 GOLDEN GATE PKWY
WENTZVILLE
MO
633857288
Provider Mailing Phone/Fax
| Phone: | 3143977219 |
| Fax: |