Provider Demographics
NPI:1720139587
Name:FRIEND, CHARIA LOUISE (CRNP)
Entity Type:Individual
Prefix:
First Name:CHARIA
Middle Name:LOUISE
Last Name:FRIEND
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 WINDING BROOK WAY
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-1686
Mailing Address - Country:US
Mailing Address - Phone:410-944-0077
Mailing Address - Fax:
Practice Address - Street 1:6085 MARSHALEE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6023
Practice Address - Country:US
Practice Address - Phone:443-756-9176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR147658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD336513100OtherMEDICAL ASSISTANCE
DCN681-0002OtherCAREFIRST
MD01380002OtherAMERIGROUP
MD96266102OtherCAREFIRST
GAP00900535OtherRAILROAD MEDICARE
MD169641ZBQKOtherMEDICARE