Individual provider Active NPI

Nathan M Friese

  • Registered Nurse
  • Saint Clair Shores, MI
National Provider Identifier
1063329134
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704335683 Issued in MI
Practice address
21236 Bon Brae St
Saint Clair Shores, MI 48081-1853
Phone
(586) 381-6708
NPI assigned
Aug 25, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 4704335683 MI Primary

Addresses

Primary practice location

21236 Bon Brae St
Saint Clair Shores, MI 48081-1853

Mailing address

21236 Bon Brae St
Saint Clair Shores, MI 48081-1853
Phone (586) 381-6708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1787616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1063329134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21236 BON BRAE ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811853",
            "telephone_number": "586-381-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21236 BON BRAE ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811853",
            "telephone_number": "586-381-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIESE",
        "first_name": "NATHAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704335683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.