Healthcare Provider Details

I. General information

NPI: 1467252247
Provider Name (Legal Business Name): KAITLIN LAWS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAITLIN KOROSCHETZ

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 MEDICAL CENTER DR STE 102
WILMINGTON NC
28401-4250
US

IV. Provider business mailing address

6403 OLD FORT RD
WILMINGTON NC
28411-4772
US

V. Phone/Fax

Practice location:
  • Phone: 910-452-3666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberF0325036
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: