| Doctor Name: | MS. KATHREEN KELLI FRIEND |
| NPI Number: | 1508005562 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PEDIATRIC NURSE PRAC |
| License Number: | 2002019510 |
| Business Practice Address: | 109 Leroux St Doniphan, MO - 639351038 |
| Business Phone Number: | 5733362136 |
| Business Fax Number: | |
| Mailing Address: | 309 Sunny Acres Dr, DONIPHAN |
| State: | MO |
| Postal Code: | 639351546 |
| Phone Number: | 5739965292 |
| Fax Number: | |
| NPI Enumeration Date: | 02/16/2009 |
| NPI Last Update Date: | 10/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 2002019510 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |