Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jennifer B Fredrickson, APN

Individual provider Women's Health Nurse Practitioner · NPI 1689710402

Jennifer B Fredrickson, APN is a Nurse Practitioner in Southaven, Mississippi. Qualified in 2001, 25 years ago. Accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
25
Licensed in
MS
In the registry since
2007
What do these letters mean?
APN — Advanced Practice Nurse
The umbrella title some states use for nurse practitioners and other advanced practice nurses.

See every abbreviation used in this directory →

Practice location Address checks out

3964 Goodman Rd E Ste 131
Southaven, MS 38672-8762
Phone: (662) 856-8440
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Women's Health Nurse Practitioner (primary) Taxonomy 363LW0102X · Licence R854891 (MS)

Record details

NPI number1689710402
Entity typeIndividual (Type 1)
GenderFemale
Credentials APN
Sole proprietorNo
NPI enumeratedJanuary 29, 2007
Last updated in NPPESDecember 1, 2021
Certification dateDecember 1, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Southaven