Anita Lynn Frederick, RN

Individual provider Active NPI Home Health Registered Nurse · Mason, WI

NPI 1194780288 · NPPES record last updated Apr 8, 2008

Key facts

NPI
1194780288
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
160826-030 (WI)
Practice address
29250 County Hwy E
Mason, WI 54856-1072
Phone
(715) 765-4791
NPI assigned
Apr 20, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
160826-030WIMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Huerta and Frederick Medical Corporation Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 160826-030 WI Yes

Addresses

Primary practice location

29250 County Hwy E
Mason, WI 54856-1072

Mailing address

4736 Waisanen Rd
Embarrass, MN 55732-8346
Phone (218) 780-3164

Other providers in Mason, WI

All providers in Mason, WI · Home Health Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.