Gloria Fredericks, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP007210 Issued in PA

Practice address

255 W Lancaster Ave
Paoli Medical Building 3 Suite 234
Paoli, PA 19301-1763

Phone

(610) 647-4260

Fax

(610) 647-7430

NPI assigned

Nov 7, 2008

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1386898013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BROAD ST",
            "address_2": "3RD FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071500",
            "telephone_number": "267-479-4165",
            "fax_number": "215-463-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "address_2": "PAOLI MEDICAL BUILDING 3 SUITE 234",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "610-647-4260",
            "fax_number": "610-647-7430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "GLORIA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-07",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP007210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Foster, CRNP
• Mackenzie Foster, CRNP
• Stephen Cary Fox, M.D., FACP
• Timothy T Fox, MD
• Nicole Elizabeth Francis, PA-C
• Colleen Christine French
• Kimberly U. French, MD
• Geraldine Fried, C.R.N.P.
• Robert C Fried, MD
• Jeffrey M Friedman, MD

• Nurse Practitioner in Paoli, PA
• Providers in Paoli, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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.