Provider Demographics
NPI:1184072225
Name:FRIEDLAN, SUSAN (NP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:FRIEDLAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9755 N 90TH ST
Mailing Address - Street 2:C200
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5046
Mailing Address - Country:US
Mailing Address - Phone:480-661-1755
Mailing Address - Fax:480-661-9636
Practice Address - Street 1:9755 N 90TH ST
Practice Address - Street 2:C200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5046
Practice Address - Country:US
Practice Address - Phone:480-661-1755
Practice Address - Fax:480-661-9636
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN139039363LF0000X
AZAP8911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily