Raelynn Frederickson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

378181-3102 Issued in UT

Practice address

Department of Pharmacy Services Rma050
50 N Medical Drive
Salt Lake City, UT 84132-0001

Phone

(801) 585-3965

Fax

(801) 585-0403

NPI assigned

Aug 27, 2007

Last updated

Aug 27, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1245423805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PHARMACY SERVICES RMA050",
            "address_2": "50 N MEDICAL DRIVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-585-3965",
            "fax_number": "801-585-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PHARMACY SERVICES RMA050",
            "address_2": "50 N MEDICAL DRIVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-585-3965",
            "fax_number": "801-585-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKSON",
        "first_name": "RAELYNN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "378181-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tailer Anne Frazier
• Victoria Marie Frecentese, PA-C
• Madeleine Estelle Frech
• Alyssa Irene Fredbo, PA-C
• Marc K Frederick
• Kristin Krogue Fredrickson
• Mark Tanner Fredrickson
• Bradley Free
• Gregory Lee Freebairn, DC
• Karen Lynn Freed, MD, MPH

• Registered Nurse in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Registered Nurse in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.