IndividualActive
Fredericka Fairman
NPI 1679389944 · Nurse's Aide · Brookhaven, MS
Provider details
- NPI number
- 1679389944
- Entity type
- Individual
- Primary specialty
- Nurse's AideNursing Service Related Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 083949 (MS)
Specialties & taxonomies
Nursing Service Related Providers
Practice location
504 Eastgate Dr
Brookhaven, MS 39601-3106
Phone: (601) 748-1731
Approximate (ZIP-level) locationGet directions
Mailing address
504 Eastgate Dr
Brookhaven, MS 39601-3106
Registry dates
- Enumerated
- 2024-12-10
- Last updated
- 2025-01-01
- Certified
- 2025-01-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.