Individual
KAYTLYN K CAFFERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 NAVARRE PL STE 4470, SOUTH BEND, IN 46601-1168
(574) 647-4230
(574) 647-6532
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002205A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300006340
—
IN
Enumeration date
02/27/2017
Last updated
04/28/2021
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