FREDONIA ENTERPRISES PLLC NPI 1710730718

NPI Information

  • NPI: 1710730718
  • Provider Name: FREDONIA ENTERPRISES PLLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • :
  • Address: 302 BROADWAY ST
    MOUNT VERNON, IL
    ZIP 62864
  • Phone: (618) 204-2897

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NPI Details

FREDONIA ENTERPRISES PLLC is a family nurse practitioner in Mount Vernon, IL. FREDONIA ENTERPRISES PLLC NPI is 1710730718. The provider is registered as an organization entity type and is a single specialty group.
The provider .

The provider's business location address is:

302 BROADWAY ST
MOUNT VERNON, IL
ZIP 62864-116
Phone: (618) 204-2897
Fax: (618) 242-7674

The provider's authorized official is David A Milano .
The authorized official title is Owner and has the following contact phone number (618) 204-2897.

The enumeration date for this NPI number is 4/9/2024 and was last updated on 4/9/2025.

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
1363LF0000XNurse PractitionerFamilyYes

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: 11/21/2025

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