Individual
MS. MARY FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4041 ROWAN RD, NEW PORT RICHEY, FL 34653-6121
(727) 284-1980
(727) 284-1981
Mailing address
8310 MILL CREEK LN, HUDSON, FL 34667-2527
(727) 514-3543
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5216595
FL
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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