Provider Demographics
NPI:1770368136
Name:KINCAID, KAITLYN HOPE (PA-C)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:HOPE
Last Name:KINCAID
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:736 IKE HARVILLE LN
Mailing Address - Street 2:
Mailing Address - City:THORN HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37881-3409
Mailing Address - Country:US
Mailing Address - Phone:865-805-4425
Mailing Address - Fax:
Practice Address - Street 1:1850 OLD KNOXVILLE RD
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:TN
Practice Address - Zip Code:37879-3625
Practice Address - Country:US
Practice Address - Phone:423-626-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical