Kaitlyn Victoria Fredrick, APN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN290699 Issued in GA

Practice address

1525 Clifton Rd NE
Atlanta, GA 30322-4200

Phone

(404) 727-6145

NPI assigned

Aug 31, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1952778441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 JOSEPHINE ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303072002",
            "telephone_number": "901-496-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303224200",
            "telephone_number": "404-727-6145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "319 SW Washington St",
            "address_2": "Suite 1015",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972042635",
            "country_code": "US",
            "telephone_number": "503-489-8804",
            "fax_number": "503-227-2561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41 Perimeter Ctr E Ste 250",
            "address_purpose": "LOCATION",
            "city": "Dunwoody",
            "state": "GA",
            "postal_code": "30346",
            "country_code": "US",
            "telephone_number": "770-871-3726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDRICK",
        "first_name": "KAITLYN",
        "middle_name": "VICTORIA",
        "credential": "APN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2021-06-11",
        "certification_date": "2021-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201509309NP-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN290699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margrethe Ann Fredericks, CPNP
• Amanda Frederking
• Jennifer Koren Frediani, R.D., L.D., ACSM-CES
• Anna Coursey Fredlund
• Breanna Kathleen Fredrick, AA
• Robert M. Fredrick, M.S.W.
• Courtney Nicole Fredrickson, DC
• Regina Mensah Fredua-Agyeman, FNP
• Whitney Alison Free, BCBA
• Gary E. Freed, D.O.

• Psychiatric/Mental Health Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.