Provider Demographics
NPI:1700584877
Name:BARNETT, KAITLYN G
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:G
Last Name:BARNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12119 CANAL DR
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE, NC
Mailing Address - State:NC
Mailing Address - Zip Code:28078
Mailing Address - Country:US
Mailing Address - Phone:502-667-0364
Mailing Address - Fax:
Practice Address - Street 1:12119 CANAL DR
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE, NC
Practice Address - State:NC
Practice Address - Zip Code:28078
Practice Address - Country:US
Practice Address - Phone:502-667-0364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2023000893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily