Individual
MS. JEANNINE F FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
121 SUMNER ST, COVINGTON, LA 70433-1565
(985) 630-1866
Mailing address
121 SUMNER ST, COVINGTON, LA 70433-1565
(985) 630-1866
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN078775-AP05838
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2349988
—
LA
Enumeration date
01/06/2012
Last updated
09/29/2025
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