Individual
MS. KATHREEN KELLI FRIEND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEDIATRIC NURSE PRAC
Contact information
Practice address
109 LEROUX ST, DONIPHAN, MO 63935-1038
(573) 336-2136
Mailing address
309 SUNNY ACRES DR, DONIPHAN, MO 63935-1546
(573) 996-5292
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2002019510
MO
Other
Enumeration date
02/16/2009
Last updated
10/02/2012
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