Individual
BETH FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
620 8TH AVE, TERRE HAUTE, IN 47804-2771
(812) 231-8323
Mailing address
620 8TH AVE, TERRE HAUTE, IN 47804-2771
(812) 231-8323
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71010646A
IN
Other
Enumeration date
12/07/2020
Last updated
01/13/2021
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