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General NPI Number Information
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NPI Number | 1093440414
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Entity Type | Individual
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Provider Name | KAITLIN BARELA KAITLIN BARELA CSFA
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Gender | Female
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 1050 W GALLERIA DR
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City | HENDERSON
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State | NV
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Zip | 89011-4800
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Country | US
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Telephone | 702-963-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 6812 MAHOGANY MEADOWS AVE
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City | LAS VEGAS
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State | NV
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Zip | 89122-8603
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Country | US
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Telephone | 657-378-8301
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZX2200X
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Taxonomy Name | Orthopedic Assistant
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License Number | 196514
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 196514
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License Number State | NV
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