Individual
MA. THERESA CORPUZ FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, AGPCNP-BC
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
11200-33
WI
Other
Enumeration date
08/16/2021
Last updated
07/31/2024
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