Provider Demographics
NPI:1235907528
Name:FRIDAY, SIMON (BA)
Entity Type:Individual
Prefix:
First Name:SIMON
Middle Name:
Last Name:FRIDAY
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 LYNN DR APT 4
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5746
Mailing Address - Country:US
Mailing Address - Phone:907-518-1459
Mailing Address - Fax:
Practice Address - Street 1:3801 UNIVERSITY LAKE DR STE 205
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4658
Practice Address - Country:US
Practice Address - Phone:907-729-2492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker