KELLY FREDERICK (NPI# 1841689395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841689395 |
| Entity Type | Individual |
| Full Name | KELLY FREDERICK |
| Credential | RN, MSN, FNP |
| Practice Address |
11842 Rock Landing Dr Suite 100 Newport News VA 23606-4437 |
| Practice Telephone | 7578730338 |
| Practice Fax Number | 7578739579 |
| Mailing Telephone | 7578730338 |
| Mailing Fax Number | 7578739579 |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2015-01-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024172246 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588112015 | Kelly Damian Frederick | Funeral Director | 1543 Ligonier St, Latrobe, PA 15650-2955 | 2016-09-13 |
| 1821652876 | Kelly K Frederick | Behavior Technician | 10313 Aboite Center Rd, Fort Wayne, IN 46804-5435 | 2019-04-25 |
| 1578923694 | Kelly Frederick | Licensed Practical Nurse | 6605 W Central Ave, Toledo, OH 43617-1000 | 2016-03-02 |
| Street Address |
11842 ROCK LANDING DR SUITE 100 |
| City | NEWPORT NEWS |
| State | VA |
| Zip Code | 23606-4437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588647366 | Numa Ray Lee | Dentist | 11842 Rock Landing Dr, Newport News, VA 23606-4437 | 2005-11-25 |
| 1417292996 | Andrea L Conley | Nurse Practitioner | 11842 Rock Landing Dr, Suite 115, Newport News, VA 23606-4437 | 2012-12-10 |
| 1013267400 | Andrea Krans Nelson | Nurse Practitioner | 11842 Rock Landing Dr, Ste 115, Newport News, VA 23606-4437 | 2012-09-13 |
| 1083993935 | Numa Ray Lee Dds Pllc | Dentist | 11842 Rock Landing Dr, Suite 105, Newport News, VA 23606-4437 | 2011-08-10 |
| 1851550206 | Adam Nathaniel Gold | Chiropractor | 11842 Rock Landing Dr, Suite 110, Newport News, VA 23606-4437 | 2008-06-02 |
| 1710170105 | Barbara Smith Haywood | Nurse Practitioner | 11842 Rock Landing Dr, Sutie 115, Newport News, VA 23606-4437 | 2007-08-20 |
| 1053466631 | Ryan Hester | Otolaryngology | 11842 Rock Landing Dr, Suite 100, Newport News, VA 23606-4437 | 2007-01-24 |
| 1578652137 | Mid-atlantic Womens Care Plc | Specialist | 11842 Rock Landing Dr, Suite 115, Newport News, VA 23606-4437 | 2006-10-12 |
| 1013028620 | Linda M. Serwatka | Dermatology | 11842 Rock Landing Dr, Suite 120, Newport News, VA 23606-4437 | 2006-08-31 |
| 1295756021 | Kim Scott Charney, D.c. P.C. | Chiropractor | 11842 Rock Landing Dr, Suite 110, Newport News, VA 23606-4437 | 2006-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841815412 | Orthopaedic Surgery & Sports Med Specialist of Hampton Rds PC | Clinic/Center | 580 City Center Blvd, Newport News, VA 23606 | 2020-06-10 |
| 1457907453 | Children of The Kingdom Home Health Care Services LLC | Home Health | 11834 Cannon Blvd., Ste I-4, Newport News, VA 23606 | 2019-08-15 |
| 1730651282 | Asia Denise Gordon | Family Medicine | 12715 Warwick Blvd # M&o, Newport News, VA 23606 | 2018-12-21 |
| 1447732870 | Jean Ann Kimbrel | Counselor | 105 Nat Turner Blvd, Newport News, VA 23606 | 2018-09-01 |
| 1649762816 | Paige Tretter | Physical Therapist | Orthopaedic and Spine Center, 250 Nat Turner Blvd, Newport News, VA 23606 | 2018-06-04 |
| 1447753959 | Milov Margaret Sonnier | Social Worker | 739 Thimble Shoals Blvd Ste 704, Newport News, VA 23606 | 2018-03-10 |
| 1033627740 | F&n Home Health Agency, LLC | Home Health | 751 Thimble Shoals Blvd Ste D1, Newport News, VA 23606 | 2018-01-16 |
| 1962858944 | Helen G Arnold | Family Medicine | 12715 Warwick Blvd Ste M&o, Newport News, VA 23606 | 2016-05-10 |
| 1780089474 | Emily Giordano | Occupational Therapist | 1000 Lakefront Commons, Apt 210, Newport News, VA 23606 | 2014-10-24 |
| 1982043345 | Kreative Milestones Behavioral Healthcare Services | Clinic/Center | 12388 Warwick Blvd Ste 306, Newport News, VA 23606 | 2013-06-19 |
| Find all providers in zip 23606 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316565179 | Rosemarie Eason Mcfather | Nurse Practitioner | 223 Hawser Bnd, Newport News, VA 23606-1551 | 2020-07-08 |
| 1629600127 | Deja Keeara Hunt | Nurse Practitioner | 704 Thimble Shoals Blvd Ste 700, Newport News, VA 23606-4544 | 2020-02-12 |
| 1629555727 | Leslie D Koberstein | Nurse Practitioner | 11835 Fishing Point Dr Ste 104, Newport News, VA 23606-2584 | 2018-07-23 |
| 1770088924 | Eehim Inc | Nurse Practitioner | 714 J Clyde Morris Blvd Ste 160, Newport News, VA 23601-1500 | 2018-03-29 |
| 1336664689 | Kelly Gates Armbruster | Nurse Practitioner | 1004 Old Denbigh Blvd, Newport News, VA 23602-2017 | 2017-08-08 |
| 1295264364 | Taemin Kim | Nurse Practitioner | 934 Nicklaus Dr, Newport News, VA 23602-8895 | 2017-06-12 |
| 1548714272 | Sharon Parker Sample | Nurse Practitioner | 822 Mccrae Dr, Newport News, VA 23608-9360 | 2016-08-11 |
| 1861856577 | Latoya Shant'e Kearney | Nurse Practitioner | 1405 Kiln Creek Pkwy Ste K, Newport News, VA 23602-9700 | 2016-04-08 |
| 1134512759 | Mesheal Gurst | Nurse Practitioner | 826 Chapin Wood Dr, Newport News, VA 23608-4006 | 2015-03-06 |
| 1962814376 | Stephanie Heaton King | Nurse Practitioner | 13000 Warwick Blvd # 8497, Newport News, VA 23602 | 2014-05-20 |
| Find all providers in NEWPORT NEWS | ||||
| City | NEWPORT NEWS |
| Zip Code | 23606 |
Please comment or provide details below to improve the information on KELLY FREDERICK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.