| Doctor Name: | MR. ROBERT KEITH FREDREGILL |
| NPI Number: | 1699754960 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | 668955 |
| Business Practice Address: | 1 Jarrett White Rd Tripler Army Medical Center Tamc, HI - 968595001 |
| Business Phone Number: | 8084332132 |
| Business Fax Number: | |
| Mailing Address: | 427 Halawa View Loop, 101 HONOLULU |
| State: | HI |
| Postal Code: | 968187386 |
| Phone Number: | 8088343534 |
| Fax Number: | |
| NPI Enumeration Date: | 01/13/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 668955 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |