Healthcare Provider Details

I. General information

NPI: 1093632440
Provider Name (Legal Business Name): KAITLYN JADE SPYCHAJ BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 RESERVOIR RD NW
WASHINGTON DC
20007-2111
US

IV. Provider business mailing address

348 SAMUEL RD
LORIS SC
29569-5773
US

V. Phone/Fax

Practice location:
  • Phone: 202-867-0100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number272832
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: