Individual
KATHRYN A FRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3015 ONTARIO, SPRINGFIELD, IL 62707-9318
(178) 013-0152
(872) 231-0577
Mailing address
3015 ONTARIO, SPRINGFIELD, IL 62707-9318
(178) 013-0152
(872) 231-0577
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
277001424
IL
363LF0000X
Family Nurse Practitioner
A164096
IA
Other
Enumeration date
07/17/2015
Last updated
07/10/2021
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