Healthcare Provider Details

I. General information

NPI: 1689265803
Provider Name (Legal Business Name): NICOLE FRETTERD APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2021
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 N 12TH ST
GRAND JUNCTION CO
81501-2916
US

IV. Provider business mailing address

2140 N 12TH ST
GRAND JUNCTION CO
81501-2916
US

V. Phone/Fax

Practice location:
  • Phone: 970-579-0003
  • Fax:
Mailing address:
  • Phone: 970-579-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1002126-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: