Fredricks, Kim

Fredricks, Kim is an sole proprietor health care provider with primary practice located at 1200 W Granada Blvd Ste 4 , Ormond Beach FL 32174-8157. She recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Psychiatry, Allopathic & Osteopathic Physicians / Behavioral Neurology & Neuropsychiatry, Allopathic & Osteopathic Physicians / Addiction Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities. Allopathic & Osteopathic Physicians / Behavioral Neurology & Neuropsychiatry is her primary health care specialty. Fredricks, Kim can be contacted via phone (386) 983-4147.

Contact Information

Primary practice address
1200 W Granada Blvd Ste 4 Ormond Beach FL 32174-8157
Phone: (386) 983-4147
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X RN9508898 Florida
Allopathic & Osteopathic Physicians / Behavioral Neurology & Neuropsychiatry 2084B0040X RN9508898 Florida
Allopathic & Osteopathic Physicians / Addiction Psychiatry 2084P0802X RN9508898 Florida
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X RN9508898 Florida
Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities 2084P0005X RN9508898 Florida

Profile Details

NPI number 1104749068
LBN Legal business name Fredricks, Kim
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 30th, 2026
Last updated Aug 17th, 2026 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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