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General NPI Number Information
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NPI Number | 1376992313
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Entity Type | Individual
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Provider Name | FREDRICKA MARSH DNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 9900 BREN RD E, MAIL ROUTE MN 008-B213
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City | MINNETONKA
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State | MN
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Zip | 55343-9664
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Country | US
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Telephone | 954-299-2498
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Fax |
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Provider Business Mailing Address
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Address Line | 2111 SW 35TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-3627
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Country | US
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Telephone | 954-257-2601
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9184714
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License Number State | FL
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