MEDICARE: JEAN FRIEDMAN CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	04130NP	OH
2	163W00000X	Registered Nurse	RN094433	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336150499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN FRIEDMAN CNP

Provider Business Mailing Address
First Line	:	25350 ROCKSIDE RD
Second Line	:	SUITE 100
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146-7110
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25350 ROCKSIDE RD
Second Line	:	SUITE 100
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146-7110
Country	:	US
Telephone Number	:	440-232-8381
Fax Number	:	440-374-4967

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	01/24/2014

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