Healthcare Provider Details

I. General information

NPI: 1851070742
Provider Name (Legal Business Name): KATIE FRIEDMAN WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 HADDON AVE
CAMDEN NJ
08103-3109
US

IV. Provider business mailing address

1601 HADDON AVE
CAMDEN NJ
08103-3109
US

V. Phone/Fax

Practice location:
  • Phone: 856-757-3700
  • Fax:
Mailing address:
  • Phone: 856-757-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP024070
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ14865100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: