MEDICARE: MS. KAITLIN DIANE APOSTOL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP030364	PA

General Provider Information

NPI Number	:	1477384329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAITLIN DIANE APOSTOL

Provider Business Mailing Address
First Line	:	1334 S DOVER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-3622
Country	:	US
Telephone Number	:	484-478-4199
Fax Number	:

Provider Business Practice Location Address
First Line	:	2913 KENSINGTON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-3016
Country	:	US
Telephone Number	:	215-634-5272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	01/30/2025

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