ELISE FREDEKING NP-C
NPI 1669028759
Nurse Practitioner in Panama City, FL

Q: What is Elise Fredeking's NPI number?

The NPI number for Elise Fredeking is 1669028759. It was assigned to this individual provider in the NPPES registry on August 14, 2019.

Q: What is Elise Fredeking's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Elise Fredeking was last updated on April 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 14, 2019

2100 STATE AVE, PANAMA CITY, FL 32405(850) 763-0036 Get Directions Write a Review

NPPES record last updated: April 21, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 21, 2021, Aug 14, 2019 (2 updates tracked since 2019).

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About Elise Fredeking Np-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELISE FREDEKING NP-C (NPI 1669028759) is an individual nurse practitioner in Panama City, Florida, licensed in Florida (11003617) and active in the NPI registry since August 2019.

NPPES Registry Identity

NPI1669028759

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameELISE FREDEKINGCredential: NP-C

Location Address2100 STATE AVEPanama City, FL 32405-4587

Mailing Address2100 State AvePanama City, FL 32405-4587 · (209) 968-3257

Phone(850) 763-0036

Sole ProprietorNo

Enumeration DateAugust 14, 2019

Last NPPES UpdateApril 21, 20212 updates tracked since enumeration

NPPES CertifiedApril 21, 2021

✔ NPI 1669028759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in FL · 11003617

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

2100 STATE AVE, Panama City, FL 32405

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Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELLY CARVER D.O.

Internal Medicine (Hematology)