Individual
AMANDA FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1110 N SARAH DEWITT DR, GONZALES, TX 78629-3311
(830) 672-8502
(830) 541-5557
Mailing address
PO BOX 587, GONZALES, TX 78629-0587
(830) 672-9508
(830) 670-3093
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
785626
TX
363L00000X
Nurse Practitioner
Primary
1084549
TX
Other
Enumeration date
08/08/2024
Last updated
08/08/2024
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