Individual
ELIZABETH H FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
302 HUSSON AVE, SUITE 1, BANGOR, ME 04401-3374
(207) 947-6141
(207) 947-6720
Mailing address
43 WHITING HILL ROAD, SUITE 300, BANGOR, ME 04401
(207) 947-6141
(207) 947-6720
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP81009
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264090099
—
ME
Enumeration date
07/03/2006
Last updated
12/29/2016
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