Provider Demographics
NPI:1881013076
Name:SPANGLER, KAITLIN (CNM)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 JAMES WAY STE 106
Mailing Address - Street 2:
Mailing Address - City:PISMO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93449-4974
Mailing Address - Country:US
Mailing Address - Phone:805-773-3060
Mailing Address - Fax:805-269-0026
Practice Address - Street 1:2 JAMES WAY STE 106
Practice Address - Street 2:
Practice Address - City:PISMO BEACH
Practice Address - State:CA
Practice Address - Zip Code:93449-4974
Practice Address - Country:US
Practice Address - Phone:805-773-3060
Practice Address - Fax:805-269-0026
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA235644367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife