Individual
MS. ROBERTA MARIE FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1944 ACADEMY AVE, TULARE, CA 93274-3187
(559) 300-8557
Mailing address
1944 ACADEMY AVE, TULARE, CA 93274-3187
(559) 300-8557
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
VN226782
CA
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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