Provider Demographics
NPI:1609104298
Name:FRY, CATRINA LATRESE (RRT, AS, (DONA))
Entity Type:Individual
Prefix:
First Name:CATRINA
Middle Name:LATRESE
Last Name:FRY
Suffix:
Gender:F
Credentials:RRT, AS, (DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5615 W VERMONT ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-8702
Mailing Address - Country:US
Mailing Address - Phone:317-698-2030
Mailing Address - Fax:
Practice Address - Street 1:5615 W VERMONT ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-8702
Practice Address - Country:US
Practice Address - Phone:317-698-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula