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

Kelli Jean Frederickson, NP-C

Individual provider Nurse Practitioner · NPI 1659777332

Kelli Jean Frederickson, NP-C is a Nurse Practitioner in Green Bay, Wisconsin. Qualified in 2014, 12 years ago. Practices with Baycare Aurora LLC, a 199-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
12
Licensed in
WI
In the registry since
2014
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

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Practice location Address checks out

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone: (920) 288-8300
Fax: (920) 288-8305
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 6107-33 (WI)

Record details

NPI number1659777332
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP-C
Sole proprietorNo
NPI enumeratedNovember 7, 2014
Last updated in NPPESFebruary 20, 2020
Certification dateFebruary 20, 2020

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Baycare Aurora Llc — 199 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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