Kelly Marie Frederiksen, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041.393543 Issued in IL

Practice address

2433 Autumn Grove Cir
Aurora, IL 60504-5874

Phone

(815) 603-1330

NPI assigned

Dec 11, 2015

Last updated

Dec 11, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kelly Marie Frohlich Former name

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": "1449792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1568837839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2433 AUTUMN GROVE CIR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605045874",
            "telephone_number": "815-603-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2433 AUTUMN GROVE CIR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605045874",
            "telephone_number": "815-603-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERIKSEN",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.393543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "FROHLICH",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas Daniel Franz, D.C.
• Tracy Marie Frazzini, APN, FNP-BC
• Jessica Frederick, COTA/L
• Macy Frederick
• Daniella Fredericks
• Jenni Fredrickson, BA
• Jeffrey Ryan Freiberg
• Jarrod Frein, PT
• Fresenius Medical Care East Aurora, LLC (Fresenius Kidney Care East Aurora)
• Gianna Frieders

• Registered Nurse in Aurora, IL
• Providers in Aurora, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.