Individual
JULIE R FREDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
225 MEMORIAL DR, STE 1200, BERLIN, WI 54923-1243
(920) 361-5770
(920) 361-5779
Mailing address
225 MEMORIAL DR, STE 1200, BERLIN, WI 54923-1243
(920) 361-5770
(920) 361-5779
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
99850-030
WI
363L00000X
Nurse Practitioner
Primary
1682-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43827900
—
WI
Enumeration date
08/02/2005
Last updated
10/24/2014
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