Individual
MR. GEORGE FREDERICKS IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1913 HIGHWAY 394, BLOUNTVILLE, TN 37617-5349
(423) 662-7002
(423) 662-7003
Mailing address
1913 HIGHWAY 394, BLOUNTVILLE, TN 37617-5349
(423) 662-7002
(423) 662-7003
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0000192577
TN
363LF0000X
Family Nurse Practitioner
Primary
32503
TN
Other
Enumeration date
08/31/2022
Last updated
12/12/2022
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