Individual
KELLY FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, FNP
Contact information
Practice address
11842 ROCK LANDING DR, SUITE 100, NEWPORT NEWS, VA 23606-4437
(757) 873-0338
(757) 873-9579
Mailing address
11842 ROCK LANDING DR, SUITE 100, NEWPORT NEWS, VA 23606-4437
(757) 873-0338
(757) 873-9579
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024172246
VA
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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