Individual
DR. KRISTIN LEE FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3605 MAYFAIR AVE, HIBBING, MN 55746-2923
(218) 262-3441
(218) 362-6989
Mailing address
3605 MAYFAIR AVE, HIBBING, MN 55746-2923
(218) 262-3441
(218) 362-6989
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
48615
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48615
MN LIC
MN
Enumeration date
05/12/2006
Last updated
09/13/2013
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