Kaitlyn Ann Carleton

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Philo, IL

NPI 1467902882 · NPPES record last updated Oct 10, 2016

Key facts

NPI
1467902882
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
11 Kennedy CT
Philo, IL 61864-9759
Phone
(217) 722-7698
NPI assigned
Oct 10, 2016
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)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

11 Kennedy CT
Philo, IL 61864-9759

Mailing address

11 Kennedy CT
Philo, IL 61864
Phone (217) 722-7698

Other providers in Philo, IL

All providers in Philo, IL · Student in an Organized Health Care Education/Training Program in Illinois

Sources for this page

Verify at the official NPI Registry.