MRS. KATIE LEE FREDERICKSON FNP-BC NPI 1104237544

NPI Information

NPI: 1104237544
Provider Name: MRS. KATIE LEE FREDERICKSON, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2438 N PONDEROSA DR
C-105
CAMARILLO, CA
ZIP 93010
Phone: (805) 388-2068
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MRS. Katie Lee Frederickson, FNP-BC is a family nurse practitioner in Camarillo, CA. MRS. Katie Lee Frederickson, FNP-BC NPI is 1104237544. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2438 N PONDEROSA DR
C-105
CAMARILLO, CA
ZIP 93010-369
Phone: (805) 388-2068
Fax: (805) 484-7700

The NPI 1104237544 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/19/2014 and was last updated on 5/19/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	NP95000513	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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