Provider Demographics
NPI:1376969295
Name:ADVANCED REG NURSE PRACTITIONER THERAPUTIC HEATH SERVICE
Entity Type:Organization
Organization Name:ADVANCED REG NURSE PRACTITIONER THERAPUTIC HEATH SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEND
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:561-656-8200
Mailing Address - Street 1:5093 EL CLARO E
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-2701
Mailing Address - Country:US
Mailing Address - Phone:561-656-8200
Mailing Address - Fax:
Practice Address - Street 1:750 BAYBERRY DR
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-3248
Practice Address - Country:US
Practice Address - Phone:561-881-8144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1169282363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty