Provider Demographics
NPI:1184200586
Name:ARBAUGH, KAITLYN
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:ARBAUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WV
Mailing Address - Zip Code:26814-0002
Mailing Address - Country:US
Mailing Address - Phone:304-668-0189
Mailing Address - Fax:
Practice Address - Street 1:30 RIVERTON RD S
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WV
Practice Address - Zip Code:26814
Practice Address - Country:US
Practice Address - Phone:304-668-0189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker