Individual
KAITLYNN LICHT-FREIMANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4870 E JACKSON ST, MUNCIE, IN 47303-4432
(765) 287-8596
(765) 288-6514
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71014375A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103735621
ANTHEM PTAN
IN
05
—
300083467
—
IN
Enumeration date
09/28/2023
Last updated
12/18/2024
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