Provider Demographics
NPI:1528867124
Name:FRERICHS, KAELI
Entity type:Individual
Prefix:
First Name:KAELI
Middle Name:
Last Name:FRERICHS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 MANSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-2907
Mailing Address - Country:US
Mailing Address - Phone:308-390-0246
Mailing Address - Fax:
Practice Address - Street 1:1715 MANSFIELD RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2907
Practice Address - Country:US
Practice Address - Phone:308-390-0246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist