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Individual

JORDAN FREDERICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
125 BOB LAWRENCE DR, WINFIELD, AL 35594-0019
(205) 487-4535
(205) 487-8827
Mailing address
PO BOX 1140, WINFIELD, AL 35594-1140
(205) 487-4535
(205) 487-8827

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1155321
AL

Other

Enumeration date
08/08/2023
Last updated
08/08/2023
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