Provider Demographics
NPI:1558939207
Name:FRICKER, RACHEL MARIE (FNP)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:MARIE
Last Name:FRICKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-8200
Mailing Address - Fax:314-454-5244
Practice Address - Street 1:1044 N MASON RD
Practice Address - Street 2:DIV SURG UROLOGY, MOB 4 STE 230
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6431
Practice Address - Country:US
Practice Address - Phone:314-362-8200
Practice Address - Fax:314-454-5244
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2021025123363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420124781Medicaid