Healthcare Provider Details

I. General information

NPI: 1881074128
Provider Name (Legal Business Name): HEATHER FRIEDEMAN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2015
Last Update Date: 06/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 HENDERSON RD STE. 100
COLUMBUS OH
43220-4388
US

IV. Provider business mailing address

3260 HENDERSON RD STE. 100
COLUMBUS OH
43220-4388
US

V. Phone/Fax

Practice location:
  • Phone: 614-545-2002
  • Fax: 614-545-7546
Mailing address:
  • Phone: 614-545-2002
  • Fax: 614-545-7546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCOA.17351-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: