Ashley Kell Frederic, FNP-BC

Individual provider Active NPI Nurse Practitioner · Frontenac, MO

NPI 1346894052 · NPPES record last updated Jul 31, 2019

Key facts

NPI
1346894052
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
2017024417 (MO)
Practice address
607 S Lindbergh Blvd
Frontenac, MO 63131-2734
Phone
(314) 991-5438
NPI assigned
Jul 31, 2019
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2017024417MOMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2017024417 MO Yes

Addresses

Primary practice location

607 S Lindbergh Blvd
Frontenac, MO 63131-2734

Mailing address

9332 Pine Ave
Saint Louis, MO 63144-1008
Phone (314) 803-4712

Other providers in Frontenac, MO

All providers in Frontenac, MO · Nurse Practitioner in Missouri

Sources for this page

Verify at the official NPI Registry.