Healthcare Provider Details
I. General information
NPI: 1184554545
Provider Name (Legal Business Name): KAITLYN SUE QUINLAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 GENESYS PKWY
GRAND BLANC MI
48439-8065
US
IV. Provider business mailing address
1347 BUSH CREEK DR
GRAND BLANC MI
48439-1618
US
V. Phone/Fax
- Phone: 810-606-5000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 5151018251 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: