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NPI Code Detail

MEDICARE: ASHLEY RENEE FRIEDERICH APRN

MEDICARE: ASHLEY RENEE FRIEDERICH APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner209025933IL

General Provider Information

NPI Number : 1538859103
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY RENEE FRIEDERICH APRN
Provider Business Mailing Address
First Line : 3743 OLD SAINT LOUIS RD
Second Line :
City : OAKDALE
State : IL
Zip : 62268-1115
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1300 N MARKET ST
Second Line :
City : SPARTA
State : IL
Zip : 62286-1048
Country : US
Telephone Number : 618-443-2177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2023
Last Update Date : 05/08/2023

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Directions to “ ASHLEY RENEE FRIEDERICH APRN” Practice Location

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