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General NPI Number Information
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NPI Number | 1841958709
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Entity Type | Individual
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Provider Name | BOBBIE FREDERICK APRN
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Gender | Female
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Dates
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Enumeration Date | 12/07/2021
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 132 VILLAGE CENTER RD
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City | HARLAN
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State | KY
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Zip | 40831-1777
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Country | US
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Telephone | 606-573-7771
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Fax | 606-573-2809
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Provider Business Mailing Address
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Address Line | 282 HIGHWAY 2425
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City | HARLAN
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State | KY
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Zip | 40831-7063
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Country | US
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Telephone | 859-618-5520
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4015323
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1124253
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License Number State | KY
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