NICHOLAS R FREDRICKS
Individual Provider (NPI-1)
Active
Registered Nurse, Psych/Mental Health, Child & Adolescent
Provider Information
- NPI Number
1447084959- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 555 E BROADWAY AVE STE 218, JACKSON, WY, 830018640
- Phone
- (307) 739-4818
Specialties & Taxonomies
Registered Nurse, Psych/Mental Health, Child & Adolescent
Primary License: WY #47072
All Addresses
MAILING
PO BOX 7005
JACKSON, WY, 830027005