Frederick, Vicki S

Frederick, Vicki S is an individual health care provider with primary practice located at 332 N Lauderdale St Ms 106, Memphis TN 38105-2729. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Frederick, Vicki S can be contacted via phone (901) 495-3006.

Contact Information

Primary practice address
332 N Lauderdale St Ms 106 Memphis TN 38105-2729
Phone: (901) 495-3006
Fax: (901) 495-3842
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 38476 Tennessee

Profile Details

NPI number 1972580603
LBN Legal business name Frederick, Vicki S
Credentials RN/NP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 23rd, 2005
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972580603 NPPES
Tennessee MEDICAID 3349546

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