Provider Demographics
NPI:1770390189
Name:MORGAN, KAITLYN RAYE
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:RAYE
Last Name:MORGAN
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 1:5401 JACKS CT
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3705
Mailing Address - Country:US
Mailing Address - Phone:443-681-8467
Mailing Address - Fax:
Practice Address - Street 1:616 MARRIOTT DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-5048
Practice Address - Country:US
Practice Address - Phone:629-802-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant