DR. O'ANN KARIN FREDSTROM


Address: 610 West Broadway, Suite L02, Jackson, WY 83001
Phone: 3077348800

DR. O'ANN KARIN FREDSTROM (NPI# 1225108657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225108657
Entity Type Individual
Full Name DR. O'ANN KARIN FREDSTROM
Credential MD
Practice Address 610 West Broadway
Suite L02
Jackson
WY 83001
Mailing Address P O Box 15540
Jackson
WY 83002
Practice Telephone 3077348800
Practice Fax Number 3077348900
Mailing Telephone 3077348800
Mailing Fax Number 3077348900
Enumeration Date 2006-11-09
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 174400000X Specialist 5032A WY Other Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
WY 113880400 05

Office Location

Street Address 610 WEST BROADWAY
SUITE L02
City JACKSON
State WY
Zip Code 83001

Providers in the same location

NPI Name Taxonomy Address Enumeration
1063539963 Dental Care of Jackson Hole, LLC Dentist 610 West Broadway, Centennial Building, Jackson, WY 83002 2007-03-23
1740304856 Paula Jo Schmidt Dentist 610 West Broadway, Jackson, WY 83001 2007-03-16

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861006108 Anne Kathleen Milburn Physical Therapist 3620 S Park Drive, Jackson, WY 83001 2020-09-03
1568009637 Katherine Pringle Ford Case Manager/Care Coordinator 2065 E. Limber Pine Road, Jackson, WY 83001 2019-12-07
1043878408 Cossette Burnham Physical Therapist Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 2019-05-31
1982169371 Cynthia Buck Huyffer Social Worker 755a Cache Creek Drive, Jackson, WY 83001 2019-02-10
1093281594 Lara Cilo Speech-Language Pathologist 1300 W. Valley Springs Road, Jackson, WY 83001 2018-10-23
1740776202 Teton Oral and Maxillofacial Surgery Dentist 1160 Alpine Ln Ste 1d, Jackson, WY 83001 2018-07-09
1437642055 Anna Yanchek Physical Therapist 1090 Us- 89, Jackson Hole, WY 83001 2018-06-08
1891200762 Tyler Ross Wright Chiropractor 1325 Us-89, Suite 108, Jackson, WY 83001 2017-12-13
1073027280 Root To Rise Counseling and Consulting, Pllc Social Worker 2033 Dandelion Court, Jackson, WY 83001 2017-11-27
1962923912 Piper Worthington Social Worker 1910 High School Rd, Jackson, WY 83001 2017-06-29
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Taxonomy Information

Taxonomy Code 174400000X
Grouping Other Service Providers
Classification Specialist

Taxonomy Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1427656818 Kimaya Jelks Specialist 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 2020-10-16
1396271565 Karlisha Britton Specialist 7 Lakeland Circle, Suite 300, Jackson, MS 39216 2017-05-10
1922545896 Paul Edward Ruttle Specialist 2640 Trader Rd, Jackson, WY 83001-8321 2017-01-30
1780121483 Andrew Callis Specialist 5303 Old Cape Rd E, Jackson, MO 63755-3850 2017-01-19
1538617055 Jonathan Parker Specialist 95 Riverport Dr, Jackson, TN 38301-5748 2016-09-13
1386096600 Miriam Bick Specialist 4 Florida Pl, Jackson, NJ 08527-1816 2016-07-11
1326429572 Alonzo Roberts Specialist 6110 Highway 18 W, Jackson, MS 39209-9322 2015-06-13
1407289275 Andrew Francis Charland Specialist N168w22224 Main St Ste E, Jackson, WI 53037-9321 2013-08-15
1265872501 Robyn Abbott Roberts Specialist 1904 Lakeland Dr, Suite D, Jackson, MS 39216-5038 2013-07-01
1053754580 Massage Revolution Specialist 210 E Capitol St, Ste M-142, Jackson, MS 39201-2306 2013-04-15
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Competitor

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City JACKSON
Zip Code 83001

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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