Basic Information
| Provider Information | |||||||||
| NPI: | 1235766353 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRIEDLANDER | ||||||||
| FirstName: | KELLY | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 455 PINELLAS ST STE 330 | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337563369 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7277248611 | ||||||||
| FaxNumber: | 7277240425 | ||||||||
| Practice Location | |||||||||
| Address1: | 455 PINELLAS ST STE 330 | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337563369 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7277248611 | ||||||||
| FaxNumber: | 7277240425 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2020 | ||||||||
| LastUpdateDate: | 03/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APRN11006006 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.