Provider Demographics
NPI:1508060591
Name:FRIEDMAN, JILL R (CRRN, CDMS, CCM)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:R
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:CRRN, CDMS, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 VANGUARD DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-5393
Mailing Address - Country:US
Mailing Address - Phone:907-344-8820
Mailing Address - Fax:907-344-9088
Practice Address - Street 1:9330 VANGUARD DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-5393
Practice Address - Country:US
Practice Address - Phone:907-344-8820
Practice Address - Fax:907-344-9088
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCM2301Medicaid