Provider Demographics
NPI:1235995523
Name:VORBACH, KAITLYNN
Entity Type:Individual
Prefix:
First Name:KAITLYNN
Middle Name:
Last Name:VORBACH
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 1:870 RURAL AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3072
Mailing Address - Country:US
Mailing Address - Phone:724-991-5615
Mailing Address - Fax:
Practice Address - Street 1:210 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:ELYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17824-9770
Practice Address - Country:US
Practice Address - Phone:844-878-5562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP448985183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist