Provider Demographics
NPI:1639611007
Name:FIELDS, FREDA ELAINE (APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:FREDA
Middle Name:ELAINE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 29TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-1932
Mailing Address - Country:US
Mailing Address - Phone:606-225-8200
Mailing Address - Fax:
Practice Address - Street 1:336 29TH ST STE 203
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-1932
Practice Address - Country:US
Practice Address - Phone:606-225-8200
Practice Address - Fax:888-606-7354
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010916363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily