Individual
MS. NICOLE LYNN FREDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5034 STAR RIDGE RD, EAU CLAIRE, WI 54703-6304
(715) 829-0489
Mailing address
5034 STAR RIDGE RD, EAU CLAIRE, WI 54703-6304
(715) 829-0489
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
194229-30
WI
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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