Healthcare Provider Details

I. General information

NPI: 1205745585
Provider Name (Legal Business Name): FRIDAH KURIA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N HILLSIDE ST
WICHITA KS
67214-4976
US

IV. Provider business mailing address

10006 E CLARK ST
WICHITA KS
67207-7740
US

V. Phone/Fax

Practice location:
  • Phone: 316-962-2000
  • Fax:
Mailing address:
  • Phone: 316-962-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-86101-082
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: