Provider Demographics
NPI:1285037697
Name:MAY, KAITLYN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KAITLYN
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 E MILLBROOK RD STE 110
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4971
Mailing Address - Country:US
Mailing Address - Phone:919-341-4012
Mailing Address - Fax:
Practice Address - Street 1:718 W CORBETT AVE
Practice Address - Street 2:
Practice Address - City:SWANSBORO
Practice Address - State:NC
Practice Address - Zip Code:28584-8452
Practice Address - Country:US
Practice Address - Phone:910-326-5588
Practice Address - Fax:910-326-6923
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0005562363AM0700X
NC0010-05886363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical