JACKIE FREDERICK

COLUMBIANA, AL
NPI1235190885
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: AL  1-029953)
Enumeration Date2006-03-31
Last Update Date2013-05-07
Business Address
-- JACKIE FREDERICK CRNP
201 OLD HIGHWAY 25 E
COLUMBIANA, AL 35051-9373
Phone number: 205-669-4884
Mailing Address
-- JACKIE FREDERICK CRNP
110 INDIAN FOREST TRL
PELHAM, AL 35124-3706
Phone number: 205-991-8422
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