Healthcare Provider Details

I. General information

NPI: 1508844465
Provider Name (Legal Business Name): MICHELE L. FRIEDMAN A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2006
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 LOGAN AVE EMERGENCY DEPARTMENT
WATERLOO IA
50703-1916
US

IV. Provider business mailing address

1825 LOGAN AVE EMERGENCY DEPARTMENT
WATERLOO IA
50703-1916
US

V. Phone/Fax

Practice location:
  • Phone: 319-235-3697
  • Fax: 319-235-3844
Mailing address:
  • Phone: 319-235-3697
  • Fax: 319-235-3844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA-104053
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: