Provider Demographics
NPI:1194870469
Name:FRIEDMAN, LINDA (CNM)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:SAN CRISTOBAL
Mailing Address - State:NM
Mailing Address - Zip Code:87564-0098
Mailing Address - Country:US
Mailing Address - Phone:505-586-0246
Mailing Address - Fax:
Practice Address - Street 1:1329 GUSDORF RD
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6282
Practice Address - Country:US
Practice Address - Phone:505-758-5001
Practice Address - Fax:505-737-5046
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM440363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology