Mr. Nicholas Henry Frederiksen
Nurse Practitioner - Gerontology Nurse Practitioner - Adult Health
3000 32nd Ave S
Fargo
, North Dakota 58103-6132
Mr. Nicholas Henry Frederiksen
Nurse Practitioner - Gerontology Nurse Practitioner - Adult Health
3000 32nd Ave S
Fargo
, North Dakota 58103-6132
(701) 364-8078
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About
Features
Specialties
- Nurse Practitioner - Adult Health
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Mr. Nicholas Henry Frederiksen
- Po Box 6001
- Fargo, ND
- Zip : 58108-6001
- Fax : (701) 364-8078
- Phone : (701) 364-8000
Second Address
- Mr. Nicholas Henry Frederiksen
- 3000 32nd Ave S
- Fargo, ND
- Zip : 58103-6132
- Fax : (701) 364-8078
- Phone : (701) 364-8000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LA2200X | Nurse Practitioner - Adult Health | R41352 | ND |
| N | 363LG0600X | Nurse Practitioner - Gerontology | R41352 | ND |
National Provider Identifier
| NPI | 1013319334 |
|---|---|
| Provider Name | Mr. Nicholas Henry Frederiksen |
| First Address | Fargo, ND 58108-6001 |
| Second Address | Fargo, ND 58103-6132 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/09/2014 |
| Last Update Date | 28/12/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1463647 | (05) | ND |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.