Provider Demographics
NPI:1285287706
Name:TRIEDMAN, NELLIE ANNE (RN)
Entity type:Individual
Prefix:MRS
First Name:NELLIE
Middle Name:ANNE
Last Name:TRIEDMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:50 RUSSELL ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-2414
Mailing Address - Country:US
Mailing Address - Phone:617-947-8491
Mailing Address - Fax:617-734-6385
Practice Address - Street 1:41 GARRISON RD
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-4445
Practice Address - Country:US
Practice Address - Phone:617-277-8107
Practice Address - Fax:617-734-6385
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-23
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2327054163W00000X, 363LP0808X
RIRN61939163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse