Provider Demographics
NPI:1619707114
Name:FRIEND, NATHANAEL STEPHEN (APRN FNP-C)
Entity type:Individual
Prefix:MR
First Name:NATHANAEL
Middle Name:STEPHEN
Last Name:FRIEND
Suffix:
Gender:M
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 RIVERFOREST DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-1642
Mailing Address - Country:US
Mailing Address - Phone:817-903-2729
Mailing Address - Fax:
Practice Address - Street 1:4611 RIVERFOREST DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1642
Practice Address - Country:US
Practice Address - Phone:817-903-2729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1168744363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner