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NPI Code Detail

MEDICARE: MRS. LISA AMY FRIEDMAN RN, MSN, CPNP

MEDICARE: MRS. LISA AMY FRIEDMAN RN, MSN, CPNP
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
1363LP0200XPediatric Nurse Practitioner662780TX
2363LP0200XPediatric Nurse PractitionerAP111980TX

General Provider Information

NPI Number : 1619970662
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA AMY FRIEDMAN RN, MSN, CPNP
Provider Business Mailing Address
First Line : 315 N SAN SABA
Second Line : SUITE 1135
City : SAN ANTONIO
State : TX
Zip : 78207-3154
Country : US
Telephone Number : 210-704-2190
Fax Number :
Provider Business Practice Location Address
First Line : 333 N SANTA ROSA
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78207-3108
Country : US
Telephone Number : 210-704-2190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 11/19/2020

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