Mrs. Kathleen Vanderreyden
NP | Nurse Practitioner | 6+ years Exp
3030 Lake Ave Ste 24, Fort Wayne
Indiana, 46805-5428
260-201-3119
Mrs. Kathleen Vanderreyden is a Fort Wayne, Indiana based nurse practitioner with 6 years of experience in . She completed her graduation in 2019. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Mrs. Kathleen Vanderreyden is 7100966A in Indiana. Her current practice location is 3030 Lake Ave Ste 24, Fort Wayne. Patients can reach her at 260-201-3119 or can fax her at 260-233-7416. Mrs. Kathleen Vanderreyden is NP and her NPI number (Unique professional ID assigned by NPPES) is 1225668312.
Mrs. Kathleen Vanderreyden has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Mrs. Kathleen Vanderreyden speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Mrs. Kathleen Vanderreyden |
| Specialization: | Nurse Practitioner (NP) |
| Gender: | Female |
| Credentials: | NP |
| Experience: | 6+ years |
| Medical School Attended: | Other |
| Graduation Year: | 2019 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 3030 Lake Ave Ste 24, Fort Wayne,
Indiana, 46805-5428 |
| Phone: | 260-201-3119 |
| Fax: | 260-233-7416 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 1557799491 |
| Enrollment ID: | I20200307000064 |
| NPI Number: | 1225668312 |
| NPI Enumeration Date: | 17 Jan, 2020 |
| NPI Last Update On: | 23 Oct, 2025 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mrs. Kathleen Vanderreyden are as mentioned below.
| License Number | Specialization | State | Status | |
| 7100966A | | Indiana | Primary | |
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Mrs. Kathleen Vanderreyden is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Cleanslate Medical Group Of Indiana Llc (4880963909) | 54 |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Mrs. Kathleen Vanderreyden
3030 Lake Ave Ste 24,
Fort Wayne, Indiana |
| Zip: | 46805-5428 |
| Phone Number: | 260-201-3119 |
| Fax Number: | 260-233-7416 |
Patients can reach Mrs. Kathleen Vanderreyden at
3030 Lake Ave Ste 24, Fort Wayne, Indiana or can
call to book an appointment on 260-201-3119.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.