Individual provider · Type 1 NPI
Nicholas R. Fredricks
Child & Adolescent Psychiatric/Mental Health Registered Nurse · Jackson, WY
NPI number
1447084959
Active
Practice location
555 E Broadway Ave Ste 218
Jackson, WY 83001-8640
Mailing address
PO Box 7005
Jackson, WY 83002-7005
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Child & Adolescent Psychiatric/Mental Health Registered Nurse Primary | 163WP0807X | 47072 (WY) |
Child & Adolescent Psychiatric/Mental Health Registered Nurse: Definition to come...
About NPI 1447084959
Nicholas R. Fredricks's National Provider Identifier is 1447084959, issued on Aug 27, 2024. The primary taxonomy on file is Child & Adolescent Psychiatric/Mental Health Registered Nurse (163WP0807X), and the practice location is in Jackson, WY. The record was last updated on Aug 27, 2024.