Provider Demographics
NPI:1801654322
Name:FRIDAY, HEATHER (FNP-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:FRIDAY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11111 NALL AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1625
Mailing Address - Country:US
Mailing Address - Phone:913-302-7183
Mailing Address - Fax:888-779-3217
Practice Address - Street 1:11111 NALL AVE STE 103
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1625
Practice Address - Country:US
Practice Address - Phone:913-302-7183
Practice Address - Fax:888-779-3217
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024009295363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily