Provider Demographics
NPI:1245718733
Name:AYERLE, KAITLYN (PA-C)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:AYERLE
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 1:601 ROBINSON PLACE CT
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2810
Mailing Address - Country:US
Mailing Address - Phone:443-867-6296
Mailing Address - Fax:
Practice Address - Street 1:9900 FRANKLIN SQUARE DR STE B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-5915
Practice Address - Country:US
Practice Address - Phone:443-481-1293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical