Kaitlyn Marie Etheridge
Individual provider Active NPI Pediatric Occupational Therapist · Supply, NC
NPI 1225845993 · NPPES record last updated Dec 16, 2024
Key facts
- NPI
- 1225845993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Occupational Therapist 225XP0200X
- Practice address
- 58 Physicians Dr NW
Supply, NC 28462-4215 - Phone
- (910) 755-5437
- NPI assigned
- Dec 16, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | |||
| Pediatric Occupational Therapist | 225XP0200X | Yes |
Addresses
Primary practice location
58 Physicians Dr NW
Supply, NC 28462-4215
Mailing address
30 Talford Dr
Wendell, NC 27591-7586
Phone (919) 880-0791
Other providers in Supply, NC
- Jonathan Nicholas Desillier
- Brandon Eric Devito
- Brenda Kay Dushek
- Edward E. Hayes M.D.LLC
- Essential Connections Consulting & Wellness Services LLC
- Fayetteville Vamc
- Kathryn Gay Flood
- John Full
- William Stewart Futch Jr.
- Galloway Sands LLC
All providers in Supply, NC · Pediatric Occupational Therapist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.