Individual
BREANNA KATHLEEN FREDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AA
Contact information
Practice address
1000 JOHNSON FERRY RD, ATLANTA, GA 30342-1606
(646) 279-3423
Mailing address
4633 NW 93RD TER, SUNRISE, FL 33351-5236
(646) 279-3423
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
—
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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