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Individual

ANNETTE FREDERICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
153 BRODHEAD RD, BETHLEHEM, PA 18017-8931
(484) 526-7035
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
RN565313
PA
363LG0600X
Gerontology Nurse Practitioner
Primary
SP017937
PA
363LG0600X
Gerontology Nurse Practitioner
TGRN035281
PA

Other

Enumeration date
09/27/2017
Last updated
10/03/2017
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