Provider Demographics
NPI:1205594082
Name:FRIESZ, KAILEY (ARNP)
Entity type:Individual
Prefix:
First Name:KAILEY
Middle Name:
Last Name:FRIESZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KAILEY
Other - Middle Name:
Other - Last Name:MCCUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:820 MEMORIAL ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PROSSER
Mailing Address - State:WA
Mailing Address - Zip Code:99350-2504
Mailing Address - Country:US
Mailing Address - Phone:509-786-5599
Mailing Address - Fax:
Practice Address - Street 1:820 MEMORIAL ST STE 3
Practice Address - Street 2:
Practice Address - City:PROSSER
Practice Address - State:WA
Practice Address - Zip Code:99350-2504
Practice Address - Country:US
Practice Address - Phone:509-786-5599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61243210363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner