Individual
KAITLYN VICTORIA FREDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, PMHNP-BC
Contact information
Practice address
1525 CLIFTON RD NE, ATLANTA, GA 30322-4200
(404) 727-6145
Mailing address
274 JOSEPHINE ST NE, ATLANTA, GA 30307-2002
(901) 496-3631
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
201509309NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN290699
GA
Other
Enumeration date
08/31/2015
Last updated
06/11/2021
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