Organization
FREDRICKSON ANESTHESIA STAFFING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER FREDRICKSON CRNA (PRESIDENT)
(512) 993-4848
Entity
Organization
Contact information
Practice address
2610 S IH 35, AUSTIN, TX 78704-5703
(512) 993-4848
Mailing address
15608 INTERLACHEN DR, AUSTIN, TX 78717-3871
(512) 993-4848
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
53524
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3665739-01
—
TX
Enumeration date
04/15/2014
Last updated
05/04/2017
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