SHELBY FREDRICKS (NPI# 1417442617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417442617 |
| Entity Type | Individual |
| Full Name | SHELBY FREDRICKS |
| Credential | DNP, CPNP-PC |
| Practice Address |
1205 S Mission St Ste 4 Mount Pleasant MI 48858-3939 |
| Practice Telephone | 9894004369 |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2019-07-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
4704307444 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1205 S MISSION ST STE 4 |
| City | MOUNT PLEASANT |
| State | MI |
| Zip Code | 48858-3939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535067 | Family Tree Maternity Center, LLC | Midwife | 5201 S. Mission Rd., Mt. Pleasant, MI 48858 | 2020-10-14 |
| 1942842471 | Isabella Citizens for Health, Inc. | Pharmacy | 2790 Health Parkway, Mt Pleasant, MI 48858 | 2019-10-16 |
| 1295299279 | Dalten Tyler Simnitch | Student in an Organized Health Care Education/Training Program | 3700 E Deerfield Rd, Lexington Ridge E01, Mount Pleasant, MI 48858 | 2019-01-24 |
| 1942773809 | Jordan Lynn Bell | Technician, Other | 798 S Whilteville Rd, Mount Pleasant, MI 48858 | 2019-01-03 |
| 1083183578 | Amanda Danielle Greene | Student in an Organized Health Care Education/Training Program | 1280 E. Campus Dr., Central Michigan University, Mt. Pleasant, MI 48858 | 2018-11-14 |
| 1891264388 | Emily Mccullen | Student in an Organized Health Care Education/Training Program | 1280 E Campus Drive, Central Michigan University, Mount Pleasant, MI 48858 | 2018-11-14 |
| 1174092662 | Nathaniel Lambie | Student in an Organized Health Care Education/Training Program | 1280 East Campus Drive, Central Michigan University, Mount Pleasant, MI 48858 | 2018-11-14 |
| 1386110872 | Megan Stahl | Social Worker | 301 S Crapo St Suite 100, Mt.pleasant, MI 48858 | 2018-10-23 |
| 1710461090 | Beverly Jean Medford | Custodial Care Facility | 9318 E. Pickard Rd., Mount Pleasant Mi, MI 48858 | 2018-09-21 |
| 1760976211 | Jen Carlesimo | Behavior Technician | Central Autism Treatment Center, 2520 S. University Park Drive, Building D, Mt. Pleasant, MI 48858 | 2018-06-19 |
| Find all providers in zip 48858 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275641144 | Shannan K. Dufault | Nurse Practitioner | 1952 Long Grove Dr Ste 202, Mount Pleasant, SC 29464-7579 | 2006-08-29 |
| 1811916869 | Donna Thompson Broach | Nurse Practitioner | 1903 Mulberry Ave, Mount Pleasant, TX 75455-2369 | 2006-07-19 |
| 1336701317 | Gregory N Smith Jr. | Nurse Practitioner | 2001 N Jefferson Ave Ste 300, Mount Pleasant, TX 75455-2375 | 2019-07-01 |
| 1861884835 | Lena Brittany Martin Ingraham | Nurse Practitioner | 2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455-2338 | 2015-02-26 |
| 1962748996 | Alice Gail Loguidice | Nurse Practitioner | 309 Wingo Way, Mount Pleasant, SC 29464-1804 | 2012-12-19 |
| 1043479181 | Linda Marie Mcdermott-gonzalez | Nurse Practitioner | 2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455-2386 | 2008-06-04 |
| 1821085721 | Pediatric Clinic, P.a. | Nurse Practitioner | 2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455-2371 | 2005-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851991061 | Sarah Elizabeth Barber | Nurse Practitioner | 12918 Lake Point Pass, Van Buren Twp, MI 48111-2243 | 2020-10-27 |
| 1730700881 | Kelsey Olinik | Nurse Practitioner | 22200 Barclay Dr, Novi, MI 48374-3874 | 2020-04-29 |
| 1467080705 | Jessica Nicole Heichel | Nurse Practitioner | 7729 Brass Creek Ct, Dexter, MI 48130-9384 | 2020-03-31 |
| 1114550506 | Katlyn Roberts | Nurse Practitioner | 60160 E 8 Mile Rd, South Lyon, MI 48178-9768 | 2020-02-13 |
| 1093351595 | Emily Janina Jamett | Nurse Practitioner | 31815 Southfield Rd Ste 10, Beverly Hills, MI 48025-5471 | 2019-11-20 |
| 1508410747 | Clorissa Diedrich | Nurse Practitioner | 829 N Center Ave Ste 130, Gaylord, MI 49735-1684 | 2019-07-25 |
| 1255895355 | Jessica Lynn Kata | Nurse Practitioner | 19229 Mack Ave Ste 28, Grosse Pointe Woods, MI 48236-2857 | 2019-01-23 |
| 1467934679 | Anita Lynn Riddle | Nurse Practitioner | 100 W. Vanburen Street, Battle Creek, MI 49017 | 2018-09-04 |
| 1285120634 | Alexandra Danko | Nurse Practitioner | 5500 Auto Club Dr Ste 160, Dearborn, MI 48126-2779 | 2018-07-09 |
| 1922501527 | Kacey Novik Schneider | Nurse Practitioner | 5119 W Bristol Rd, Flint, MI 48507-2966 | 2018-03-10 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT PLEASANT |
| Zip Code | 48858 |
Please comment or provide details below to improve the information on SHELBY FREDRICKS.
| 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.