Provider Demographics
NPI:1407170889
Name:FRIEDLY, ADRIENNE (APN)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:FRIEDLY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 N SHACKLEFORD RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-2840
Mailing Address - Country:US
Mailing Address - Phone:501-712-2571
Mailing Address - Fax:501-404-7789
Practice Address - Street 1:1115 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-7318
Practice Address - Country:US
Practice Address - Phone:501-712-2571
Practice Address - Fax:501-404-7789
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03328363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner