Kim Fredricks, PMHNP-BC
Nurse Practitioner, Psych/Mental Health in Ormond Beach, FL. Individual provider (NPI-1).
NPI number1104749068
StatusActive
Last updated in NPPESOct 21, 2026
Details
- NPI
- 1104749068
- Entity type
- Individual (NPI-1)
- Name
- Kim Fredricks
- Credential
- PMHNP-BC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 30, 2026
- Certification date
- Oct 21, 2026
- Last updated
- Oct 21, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 11049791 | FL | Yes |
Practice location
1200 W Granada Blvd Ste 4Ormond Beach, FL 32174-8157
Phone 386-983-4147
Mailing address
1200 W Granada Blvd Ste 4Ormond Beach, FL 32174-8157
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All 21 Psychiatric/Mental Health Nurse Practitioner providers in Ormond Beach · All 1,764 providers in Ormond Beach
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