Individual
DR. JOHANNA S. FRICKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
331 N BUFFALO DR, SUITE B, LAS VEGAS, NV 89145-0300
(702) 877-2520
(702) 877-2521
Mailing address
331 N BUFFALO DR, SUITE B, LAS VEGAS, NV 89145-0300
(702) 877-2520
(702) 877-2521
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
3166
NV
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
3166
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002002223
—
NV
01
—
CS09750
STATE PHARMACY
NV
Enumeration date
01/03/2006
Last updated
03/07/2023
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