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

Nicholas R Fredricks

Individual provider Child & Adolescent Psychiatric/Mental Health Registered Nurse · NPI 1447084959

Nicholas R Fredricks is a Child & Adolescent Psychiatric/Mental Health Registered Nurse in Jackson, Wyoming. Licensed in Wyoming. Registered with an NPI since 2024.

Licensed in
WY
In the registry since
2024

Practice location Address checks out

555 E Broadway Ave Ste 218
Jackson, WY 83001-8640
Phone: (307) 739-4818
Show map & directions

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

Specialties & licences

Child & Adolescent Psychiatric/Mental Health Registered Nurse (primary) Taxonomy 163WP0807X · Licence 47072 (WY)

Record details

NPI number1447084959
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 27, 2024
Last updated in NPPESAugust 27, 2024
Certification dateAugust 27, 2024
Mailing addressPo Box 7005, Jackson, WY 83002-7005