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NPI Code Detail

MEDICARE: JENNIFER LYNN FRIEDRICH M.A.

MEDICARE: JENNIFER LYNN FRIEDRICH M.A.
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
1172V00000XCommunity Health WorkerIMH6369FL
2172V00000XCommunity Health WorkerIMT982FL

General Provider Information

NPI Number : 1609047141
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYNN FRIEDRICH M.A.
Provider Business Mailing Address
First Line : 4936 SIERRA DR
Second Line :
City : PENSACOLA
State : FL
Zip : 32526-1714
Country : US
Telephone Number : 850-346-6004
Fax Number : 850-595-0180
Provider Business Practice Location Address
First Line : 1300 N PALAFOX ST STE 103
Second Line :
City : PENSACOLA
State : FL
Zip : 32501-2678
Country : US
Telephone Number : 850-266-2700
Fax Number : 850-595-0180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2008
Last Update Date : 03/12/2008

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