Individual provider Active NPI

Kristina Clare Friedrichs, APRN AGNP-C

  • Adult Health Nurse Practitioner
  • Wayzata, MN
National Provider Identifier
1801608088
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
11134 Issued in MN
Practice address
317 Wayzata Blvd E
Wayzata, MN 55391-1683
Phone
(952) 473-1111
NPI assigned
Jan 23, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 11134 MN
Adult Health Nurse Practitioner 363LA2200X 11134 MN Primary

Addresses

Primary practice location

317 Wayzata Blvd E
Wayzata, MN 55391-1683

Mailing address

8789 Boulder Rise
Eden Prairie, MN 55347-2420
Phone (952) 913-1216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11134MNMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1801608088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8789 BOULDER RISE",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553472420",
            "telephone_number": "952-913-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 WAYZATA BLVD E",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911683",
            "telephone_number": "952-473-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDRICHS",
        "first_name": "KRISTINA",
        "middle_name": "CLARE",
        "name_prefix": "Mrs.",
        "credential": "APRN AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "11134",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "11134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayzata, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.