MEDICARE: KRISTEN MICHELLE FRIEND MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	14242850	NC

General Provider Information

NPI Number	:	1366002230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN MICHELLE FRIEND MA

Provider Business Mailing Address
First Line	:	110 COUNTRY CLUB DR
Second Line	:
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-3261
Country	:	US
Telephone Number	:	336-870-3386
Fax Number	:

Provider Business Practice Location Address
First Line	:	1062 NORTHSIDE RD
Second Line	:
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-8522
Country	:	US
Telephone Number	:	252-335-2033
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2019
Last Update Date	:	03/19/2026

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Directions to “ KRISTEN MICHELLE FRIEND MA” Practice Location

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