Healthcare Provider Details

I. General information

NPI: 1164310066
Provider Name (Legal Business Name): NATALIE FRERIKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10012 W CAPITOL DR
MILWAUKEE WI
53222-1338
US

IV. Provider business mailing address

5731 W ROGERS ST
MILWAUKEE WI
53219-1533
US

V. Phone/Fax

Practice location:
  • Phone: 414-810-4844
  • Fax:
Mailing address:
  • Phone: 414-265-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number135596121
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: