Provider Demographics
NPI:1467988246
Name:KIRIMI, FRIDAH (ARNP)
Entity Type:Individual
Prefix:
First Name:FRIDAH
Middle Name:
Last Name:KIRIMI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7015 A C SKINNER PKWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6932
Mailing Address - Country:US
Mailing Address - Phone:904-363-2113
Mailing Address - Fax:904-363-2606
Practice Address - Street 1:14546 OLD SAINT AUGUSTINE RD
Practice Address - Street 2:BLDG 1 SUITE 317
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5468
Practice Address - Country:US
Practice Address - Phone:904-260-9445
Practice Address - Fax:904-260-0005
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9273605363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020913300Medicaid
FLIY693ZOtherMEDICARE
FL4WPVSOtherFLORIDA BLUE