Healthcare Provider Details

I. General information

NPI: 1306783543
Provider Name (Legal Business Name): KAYLEE FRYE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 S SUMMIT AVE
SIOUX FALLS SD
57197-0001
US

IV. Provider business mailing address

7232 W CHESAPEAKE LN
SIOUX FALLS SD
57106-3857
US

V. Phone/Fax

Practice location:
  • Phone: 605-321-3075
  • Fax:
Mailing address:
  • Phone: 605-321-3075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: