Basic Information
| Provider Information | |||||||||
| NPI: | 1750785333 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOOS | ||||||||
| FirstName: | KAITLIN | ||||||||
| MiddleName: | AYNSLEY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8410 EXMOOR TRCE | ||||||||
| Address2: | |||||||||
| City: | BROWNS SUMMIT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272149879 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196052417 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3701 NW CARY PKWY STE 301 | ||||||||
| Address2: | |||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192356415 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2014 | ||||||||
| LastUpdateDate: | 07/31/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 5007265 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.