Provider Demographics
NPI:1184474421
Name:BRONTE, KAITLYNN ARIEL (ND, MS)
Entity type:Individual
Prefix:
First Name:KAITLYNN
Middle Name:ARIEL
Last Name:BRONTE
Suffix:
Gender:F
Credentials:ND, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 NE 7TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1415
Mailing Address - Country:US
Mailing Address - Phone:541-656-1199
Mailing Address - Fax:
Practice Address - Street 1:1100 NE 7TH ST STE C
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1415
Practice Address - Country:US
Practice Address - Phone:541-656-1199
Practice Address - Fax:541-656-1199
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5039175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath