Individual
MS. PATRICIA LEE FREDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1 CHILDRENS PL, DIV PED NEPHROLOGY, SAINT LOUIS, MO 63110-1002
(314) 454-6043
(888) 463-6898
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-6043
(888) 463-6898
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2014023964
MO
363LP0200X
Pediatric Nurse Practitioner
Primary
2014023964
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420040522
—
MO
Enumeration date
09/18/2014
Last updated
04/17/2025
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