Individual
MS. CHERYL LYNN FREDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
925 HIGHWAY V V, KENNETT, MO 63857
(573) 717-7059
Mailing address
1201 ELY ST, KENNETT, MO 63857-1336
(573) 717-7059
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
2006025554
MO
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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