Provider Demographics
NPI:1013283555
Name:FRIED, KRISTEN JEANNE (MD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:JEANNE
Last Name:FRIED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 6TH ST E
Mailing Address - Street 2:#821
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-4911
Mailing Address - Country:US
Mailing Address - Phone:816-404-0886
Mailing Address - Fax:
Practice Address - Street 1:971 SIBLEY MEMORIAL HWY STE 350
Practice Address - Street 2:
Practice Address - City:LILYDALE
Practice Address - State:MN
Practice Address - Zip Code:55118-2856
Practice Address - Country:US
Practice Address - Phone:651-770-3320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN61047207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology