Provider Demographics
NPI:1528296621
Name:IRIYE, JEANNETTE FRIDRICH (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:FRIDRICH
Last Name:IRIYE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2633 CENTENNIAL BLVD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-0585
Mailing Address - Country:US
Mailing Address - Phone:850-877-7387
Mailing Address - Fax:850-656-3376
Practice Address - Street 1:1300 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4646
Practice Address - Country:US
Practice Address - Phone:850-216-0100
Practice Address - Fax:850-216-0180
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3254892363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily