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1659777332
KELLI JEAN FREDERICKSON
GREEN BAY, WI
NPI
1659777332
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: WI 6107-33)
Enumeration Date
2014-11-07
Last Update Date
2020-02-20
Business Address
KELLI JEAN FREDERICKSON NP-C
2845 GREENBRIER RD
GREEN BAY, WI 54311-6519
Phone number: 920-288-8300
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Mailing Address
KELLI JEAN FREDERICKSON NP-C
164 N BROADWAY
GREEN BAY, WI 54303-2728
Phone number:
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