Healthcare Provider Details

I. General information

NPI: 1932419587
Provider Name (Legal Business Name): RHONDA CHRISTINE FRERICKS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2010
Last Update Date: 10/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 WASHINGTON ST
MONTICELLO MN
55362
US

IV. Provider business mailing address

1321 13TH ST N
ST. CLOUD MN
56303
US

V. Phone/Fax

Practice location:
  • Phone: 763-295-4001
  • Fax: 763-295-5086
Mailing address:
  • Phone: 320-252-5010
  • Fax: 320-203-1855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR189776-2
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: