Individual
LYNN FREDERICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
439 NW NORTH SHORE DR, LAKE WAUKOMIS, MO 64151-1453
(816) 674-1240
Mailing address
439 NW NORTH SHORE DR, LAKE WAUKOMIS, MO 64151-1453
(816) 674-1240
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
2009012185
MO
Other
Enumeration date
07/25/2025
Last updated
07/25/2025
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