Fricke, Johanna S.

Fricke, Johanna S. is an sole proprietor health care provider with primary practice located at 331 N Buffalo Dr Suite B, Las Vegas NV 89145-0300. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics. Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics is her primary health care specialty. Fricke, Johanna S. can be contacted via phone (702) 877-2520.

Contact Information

Primary practice address
331 N Buffalo Dr Suite B Las Vegas NV 89145-0300
Phone: (702) 877-2520
Fax: (702) 877-2521
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 3166 Nevada
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X 3166 Nevada

Profile Details

NPI number 1801874631
LBN Legal business name Fricke, Johanna S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 3rd, 2006
Last updated Mar 7th, 2023 - about 3 years 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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Identifiers

StateTypeNumberIssuer
All States NPI 1801874631 NPPES
Nevada MEDICAID 002002223
Nevada Other CS09750

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