Provider Demographics
NPI:1649593112
Name:FREDERICK, KAREN LYNN (MSN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNN
Last Name:FREDERICK
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-0525
Mailing Address - Country:US
Mailing Address - Phone:731-986-2213
Mailing Address - Fax:731-986-0011
Practice Address - Street 1:306 HIGHWAY 641 N
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:TN
Practice Address - Zip Code:38320-3012
Practice Address - Country:US
Practice Address - Phone:731-584-1523
Practice Address - Fax:731-584-1543
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN14836363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily