Provider Demographics
NPI:1558716704
Name:KILIAN, KAITLIN ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:ELIZABETH
Last Name:KILIAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3833 WORSHAM AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1745
Mailing Address - Country:US
Mailing Address - Phone:562-595-5421
Mailing Address - Fax:562-426-2862
Practice Address - Street 1:3833 WORSHAM AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1745
Practice Address - Country:US
Practice Address - Phone:562-595-5421
Practice Address - Fax:562-426-2862
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95003687363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner