Provider Demographics
NPI:1649315599
Name:FRIEDMAN, NEDRA LEE (RN, MS, CS)
Entity type:Individual
Prefix:MS
First Name:NEDRA
Middle Name:LEE
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:RN, MS, CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 WESTBORO RD
Mailing Address - Street 2:
Mailing Address - City:UPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01568-1034
Mailing Address - Country:US
Mailing Address - Phone:508-603-1667
Mailing Address - Fax:503-961-9316
Practice Address - Street 1:72 WESTBORO RD
Practice Address - Street 2:
Practice Address - City:UPTON
Practice Address - State:MA
Practice Address - Zip Code:01568-1034
Practice Address - Country:US
Practice Address - Phone:508-533-5760
Practice Address - Fax:503-961-9316
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA127969364SP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health