Individual
MRS. MELISSA LYNN FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
430 LIBERTY RD, WEST LIBERTY, KY 41472
(606) 743-3114
(606) 743-1404
Mailing address
PO BOX 607, WEST LIBERTY, KY 41472-0607
(606) 743-3114
(606) 743-1404
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4360P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78012606
—
KY
Enumeration date
08/31/2006
Last updated
03/09/2011
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