Provider Demographics
NPI:1477293181
Name:FRIEND, JUDITH ANN
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:FRIEND
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 1:164 TOWNSHIP ROAD 207
Mailing Address - Street 2:
Mailing Address - City:PEDRO
Mailing Address - State:OH
Mailing Address - Zip Code:45659-8758
Mailing Address - Country:US
Mailing Address - Phone:740-643-1821
Mailing Address - Fax:
Practice Address - Street 1:275 N 3RD ST APT 307
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1463
Practice Address - Country:US
Practice Address - Phone:740-533-9358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant