Provider Demographics
NPI:1366012924
Name:MELTON, KAITLAN (PA-C)
Entity Type:Individual
Prefix:
First Name:KAITLAN
Middle Name:
Last Name:MELTON
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Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:5702 KNIGHTSBRIDGE CT APT 107
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-4453
Mailing Address - Country:US
Mailing Address - Phone:601-660-5905
Mailing Address - Fax:
Practice Address - Street 1:4710 SPOTSYLVANIA PKWY STE 201
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-9433
Practice Address - Country:US
Practice Address - Phone:540-374-3233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-09-13
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant