Jessica Dyan Friesz, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2012032038 Issued in MO

Practice address

3531 Stardust Dr
Hannibal, MO 63401-6224

Phone

(573) 603-1460

Fax

(573) 603-1462

NPI assigned

Jul 14, 2021

Last updated

Jul 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1700458254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 OLD SOUTH RIVER RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633034120",
            "telephone_number": "636-224-1210",
            "fax_number": "636-946-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3531 STARDUST DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016224",
            "telephone_number": "573-603-1460",
            "fax_number": "573-603-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIESZ",
        "first_name": "JESSICA",
        "middle_name": "DYAN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043125358",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2012032038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Freeman, RDH
• Mary J. Freymuth
• Michelle N Friedersdorf, D.P.M.
• Scott C Friedersdorf, D.P.M.
• Friends Are Family, Inc.
• Sara Galliher, FNP-BC
• John Gamble III, M.D.
• Lisa Michelle Gard, M.D.
• Scott Alan Gard, M.D.
• Emily Garrett, PHARMD

• Licensed Practical Nurse in Hannibal, MO
• Providers in Hannibal, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.