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General NPI Number Information
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NPI Number | 1528748811
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Entity Type | Individual
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Provider Name | CONSTANCE MARIE FRIEDL PMHNP
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Gender | Female
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 4100 FAIRWAY DR STE 200
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City | CARROLLTON
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State | TX
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Zip | 75010-6527
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Country | US
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Telephone | 972-221-1741
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 UECKER DR APT 11210
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City | LEWISVILLE
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State | TX
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Zip | 75067-8972
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Country | US
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Telephone | 972-965-6442
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1127801
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License Number State | TX
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