Individual
LILLIE MINETTE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
300 SUN TEMPLE DR, MADISON, AL 35758-5919
(256) 325-9111
Mailing address
300 SUN TEMPLE DR, MADISON, AL 35758-5919
(256) 325-9111
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F12210791
AL
Other
Enumeration date
07/01/2022
Last updated
07/01/2022
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