1619970662 NPI number — MRS. LISA AMY FRIEDMAN RN, MSN, CPNP

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	FRIEDMAN
Provider First Name	:	LISA
Provider Middle Name	:	AMY
Provider Name Prefix Text	:	MRS.
Provider Name Suffix Text	:
Provider Credential Text	:	RN, MSN, CPNP
Provider Gender Code	:	F

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NPI Number	:	1619970662
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	07/15/2007
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Provider First Line Business Mailing Address	:	333 N SANTA ROSA
Provider Second Line Business Mailing Address	:
Provider Business Mailing Address City Name	:	SAN ANTONIO
Provider Business Mailing Address State Name	:	TX
Provider Business Mailing Address Postal Code	:	782073108
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	2107042190
Provider Business Mailing Address Fax Number	:

Provider First Line Business Practice Location Address	:	333 N SANTA ROSA
Provider Second Line Business Practice Location Address	:
Provider Business Practice Location Address City Name	:	SAN ANTONIO
Provider Business Practice Location Address State Name	:	TX
Provider Business Practice Location Address Postal Code	:	782073108
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	2107042190
Provider Business Practice Location Address Fax Number	:
Provider Enumeration Date	:	05/23/2005

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• Taxonomy code: 363LP0200X , with the licence number:  662780 , registered in the state of TX .