Individual
RAYNETTE FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1520 NE RIDDELL RD # 110, BREMERTON, WA 98310-3005
(786) 518-8971
Mailing address
1970 NE FUSON RD APT 204, BREMERTON, WA 98311-3739
(786) 518-8971
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5173031
FL
Other
Enumeration date
10/29/2024
Last updated
10/29/2024
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