Individual
JAMIE L FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
515 BAYOU ST, VINCENNES, IN 47591-1034
(812) 886-6800
(812) 886-6809
Mailing address
PO BOX 556, VINCENNES, IN 47591-0556
(812) 494-9501
(812) 494-9502
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71008389A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300019241
—
IN
Enumeration date
08/31/2018
Last updated
02/16/2026
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