Individual
JESSICA FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1412 SWEET HOME RD STE 3-5, AMHERST, NY 14228-2795
(716) 589-1411
Mailing address
255 DELAWARE AVE STE 300, BUFFALO, NY 14202-2017
(716) 842-0440
(716) 842-4069
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
403374
NY
Other
Enumeration date
05/21/2021
Last updated
07/28/2021
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