Jackie Frederick is a Family in Pelham, Alabama. Jackie Frederick practices all healthcare services and medical treatments related to Family. The NPI Number for Jackie Frederick is 1235190885. The last update date is 2013-05-07.
Jackie Frederick's current location address is 110 Indian Forest Trl, Pelham, Alabama. You can contact this provider via phone number 2059918422 and fax number 2056694883. The mailing address for Jackie Frederick is 110 Indian Forest Trl, Pelham, Alabama. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jackie Frederick |
|---|---|
| Address | 110 Indian Forest Trl, Pelham, Alabama |
| Phone Number | 2059918422 |
| Fax Number | 2056694883 |
| Sole Proprietor | N |
| Credentials | CRNP |
NPI Number Detail
| NPI Number | 1235190885 |
|---|---|
| Provider Enumeration Date | 2006-03-31 |
| Last Updated Date | 2013-05-07 |
Provider Mailing Address Detail
| Address | 110 Indian Forest Trl |
|---|---|
| City | Pelham |
| State | Alabama (AL) |
| Post Code | 351243706 |
| Phone Number | 2059918422 |
| Fax Number | 2056694883 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 1-029953 |
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Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 60256 | AL | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Jackie Frederick by the Centers for Medicare & Medicaid Services?
The Jackie Frederick has been issued the NPI (National Provider Identifier) 1235190885. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Jackie Frederick's physical address?
The Jackie Frederick is physically located at 110 Indian Forest Trl, in the city of Pelham, AL, with the postal code 351243706.
What is Jackie Frederick's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jackie Frederick's area of specialization is Family, and the corresponding taxonomy code that categorizes this field of practice is 363Lf0000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1235190885 to Jackie Frederick?
The Centers for Medicare & Medicaid Services assigned the 1235190885 to Jackie Frederick on 2006-03-31.
As of what date were the details pertaining to Jackie Frederick last refreshed?
The information related to the Jackie Frederick, including its address, specialty, and other relevant details, was last updated on 2013-05-07.