Individual
KAITLIN E FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1500 S LAKE PARK AVE STE 204, HOBART, IN 46342-6638
(219) 947-6695
(219) 947-6092
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71014465A
IN
363LF0000X
Family Nurse Practitioner
Primary
71014465A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104121608
ANTHEM
IN
05
—
300084489
—
IN
Enumeration date
10/24/2023
Last updated
06/23/2026
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