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

Jordan Frederick, CRNP

Individual provider Nurse Practitioner · NPI 1245913367

Jordan Frederick, CRNP is a Nurse Practitioner in Winfield, Alabama. Qualified in 2023, 3 years ago. Practices with Farouk a Raquib MD PC, a 5-clinician group. Licensed in Alabama.

Years since qualifying
3
Licensed in
AL
In the registry since
2023
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

125 Bob Lawrence Dr
Winfield, AL 35594-0019
Phone: (205) 487-4535
Fax: (205) 487-8827
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 1155321 (AL)

Record details

NPI number1245913367
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedAugust 8, 2023
Last updated in NPPESAugust 8, 2023
Certification dateAugust 8, 2023
Mailing addressPo Box 1140, Winfield, AL 35594-1140

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Farouk A Raquib Md Pc — 5 clinicians
Accepts Medicare assignment Not indicated

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