Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 91-50 | NM |
N | 2080P0202X | Pediatric Cardiologist | L6384 | TX |
NPI | 1275531394 |
---|---|
Provider Name | Dr. Renee Yvette Friday |
First Address | Alamogordo, NM 88310-8704 |
Second Address | Alamogordo, NM 88310-8704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 05/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
152156903 | (05) | TX |
66604397 | (05) | NM |
G10220 | (02) |