Basic Information
| Provider Information | |||||||||
| NPI: | 1285037697 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAY | ||||||||
| FirstName: | KAITLYN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1616 E MILLBROOK RD STE 110 | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276094971 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9193414012 | ||||||||
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| Practice Location | |||||||||
| Address1: | 718 W CORBETT AVE | ||||||||
| Address2: | |||||||||
| City: | SWANSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285848452 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103265588 | ||||||||
| FaxNumber: | 9103266923 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2014 | ||||||||
| LastUpdateDate: | 06/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | C0005562 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363AM0700X | 0010-05886 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.