Provider Demographics
NPI:1316398175
Name:BARONE, KAITLYN MARIE
Entity Type:Individual
Prefix:MS
First Name:KAITLYN
Middle Name:MARIE
Last Name:BARONE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KAITLYN
Other - Middle Name:MARIE
Other - Last Name:CALDWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:436 WHITE ASH CT
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-3960
Mailing Address - Country:US
Mailing Address - Phone:513-413-1473
Mailing Address - Fax:
Practice Address - Street 1:436 WHITE ASH CT
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-3960
Practice Address - Country:US
Practice Address - Phone:513-413-1473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH404888163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse