MARJORY FREDERIC PMHNP-BC NPI 1871294447

NPI Information

  • NPI: 1871294447
  • Provider Name: MARJORY FREDERIC, PMHNP-BC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5940 S RAINBOW BLVD STE 400
    LAS VEGAS, NV
    ZIP 89118
  • Phone: (702) 854-6853

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NPI Details

Marjory Frederic, PMHNP-BC is a psychiatric/mental health nurse practitioner in Las Vegas, NV. Marjory Frederic, PMHNP-BC NPI is 1871294447. 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:

5940 S RAINBOW BLVD STE 400
LAS VEGAS, NV
ZIP 89118-507
Phone: (702) 854-6853
Fax: (702) 758-7315

The NPI 1871294447 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 3/13/2023 and was last updated on 5/24/2025.

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
1163WC0400XRegistered NurseCase ManagementRN78446NEVADANo
2363LP0808XNurse PractitionerPsychiatric/Mental Health95032219CALIFORNIANo
3363LP0808XNurse PractitionerPsychiatric/Mental Health871409NEVADAYes

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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