Fredrickson, Sara A

Fredrickson, Sara A is an individual health care provider with primary practice located at 1611 Anne St Nw , Bemidji MN 56601-5114. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Fredrickson, Sara A can be contacted via phone (218) 333-2020.

Contact Information

Primary practice address
1611 Anne St Nw Bemidji MN 56601-5114
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3005 Minnesota

Profile Details

NPI number 1407880057
LBN Legal business name Fredrickson, Sara A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Mar 7th, 2022 - about 2 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 1407880057 NPPES
Minnesota Other 375M4FR BLUE CROSS MN
Minnesota MEDICAID 539124500 BLUE CROSS MN
Minnesota Other 2202923 BLUE CROSS MN

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