Healthcare Provider Details

I. General information

NPI: 1508926882
Provider Name (Legal Business Name): JENNIFER D FRIEDMAN PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ANDERSON JENNIFER FRIEDMAN

II. Dates (important events)

Enumeration Date: 12/09/2006
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8821 COLUMBIA 100 PKWY
COLUMBIA MD
21045-2274
US

IV. Provider business mailing address

8821 COLUMBIA 100 PKWY
COLUMBIA MD
21045-2274
US

V. Phone/Fax

Practice location:
  • Phone: 410-992-0515
  • Fax: 410-740-8315
Mailing address:
  • Phone: 202-884-2020
  • Fax: 410-740-8315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR184992
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: