Provider Demographics
NPI:1609200344
Name:APTHORP, KAITLIN M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KAITLIN
Middle Name:M
Last Name:APTHORP
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 1:9201 E MOUNTAIN VIEW RD STE 115
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5140
Mailing Address - Country:US
Mailing Address - Phone:623-300-9011
Mailing Address - Fax:480-882-5821
Practice Address - Street 1:9201 E MOUNTAIN VIEW RD STE 115
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5140
Practice Address - Country:US
Practice Address - Phone:623-300-9011
Practice Address - Fax:480-882-5821
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5502363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ841651Medicaid