Doctor Name: | LINDSEY MARIE FREDERICKSEN |
NPI Number: | 1255678520 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.R.N.P |
License Number: | C-119097 |
Business Practice Address: | 40 E Hickman Rd Waukee, IA - 502635011 |
Business Phone Number: | 5159876610 |
Business Fax Number: | 5152162910 |
Mailing Address: | 40 E Hickman Rd, WAUKEE |
State: | IA |
Postal Code: | 502635011 |
Phone Number: | 5159876610 |
Fax Number: | 5152162910 |
NPI Enumeration Date: | 01/07/2013 |
NPI Last Update Date: | 01/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | C-119097 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |