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General NPI Number Information
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NPI Number | 1255255188
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Entity Type | Individual
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Provider Name | KAITLYN MADISON BRATHWAITE
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Gender | Female
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 41550 ECLECTIC ST
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City | PALM DESERT
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State | CA
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Zip | 92260-1967
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Country | US
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Telephone | 760-299-5181
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Fax |
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Provider Business Mailing Address
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Address Line | 704 GRANITE ST
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City | GREENSBORO
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State | NC
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Zip | 27403-4356
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Country | US
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Telephone | 843-424-3638
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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