Individual
MARJORY FREDERIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
5940 S RAINBOW BLVD STE 400, LAS VEGAS, NV 89118-2507
(702) 854-6853
(702) 758-7315
Mailing address
5940 S RAINBOW BLVD STE 400, LAS VEGAS, NV 89118-2507
(702) 854-6853
(702) 758-7315
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
RN78446
NV
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
871409
NV
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
95032219
CA
Other
Enumeration date
03/13/2023
Last updated
05/24/2025
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