Individual
MRS. SHEILA ANN FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
65 PATTON CEMETARY RD, FULTON, MS 38843-9353
(662) 213-8086
Mailing address
65 PATTON CEMETARY RD, FULTON, MS 38843-9353
(662) 213-8086
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
903158
MS
Other
Enumeration date
04/10/2019
Last updated
04/10/2019
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