Provider Demographics
NPI:1518151208
Name:FRIEDMAN, THERESA LOUISE (RN, MSN)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:LOUISE
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 E CARSON DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7216
Mailing Address - Country:US
Mailing Address - Phone:480-897-2744
Mailing Address - Fax:
Practice Address - Street 1:1330 E CARSON DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7216
Practice Address - Country:US
Practice Address - Phone:480-897-2744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN065054163WS0200X
AZRN065854390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No163WS0200XNursing Service ProvidersRegistered NurseSchool