MEDICARE: LINDSAY RAE FRY FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	10271	MN

General Provider Information

NPI Number	:	1689275042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY RAE FRY FNP

Provider Business Mailing Address
First Line	:	1903 S 6TH ST STE 3
Second Line	:
City	:	BRAINERD
State	:	MN
Zip	:	56401-4599
Country	:	US
Telephone Number	:	218-454-3376
Fax Number	:	218-454-4263

Provider Business Practice Location Address
First Line	:	1903 S 6TH ST STE 3
Second Line	:
City	:	BRAINERD
State	:	MN
Zip	:	56401-4599
Country	:	US
Telephone Number	:	218-454-3376
Fax Number	:	218-454-4263

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2020
Last Update Date	:	01/19/2026

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