Individual
MRS. JAMIE LYNNE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
508 MEDICAL PARK, WHEELING, WV 26003
(304) 243-8916
Mailing address
858 CO RD 20, DILLONVALE, OH 43917
(174) 073-3728
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
51393
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810010317
—
WV
Enumeration date
05/29/2007
Last updated
12/10/2007
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