Individual
MRS. KELLY MARIE FREDERIKSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2433 AUTUMN GROVE CIR, AURORA, IL 60504-5874
(815) 603-1330
Mailing address
2433 AUTUMN GROVE CIR, AURORA, IL 60504-5874
(815) 603-1330
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.393543
IL
Other
Enumeration date
12/11/2015
Last updated
12/11/2015
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