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General NPI Number Information
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NPI Number | 1407778996
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Entity Type | Individual
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Provider Name | KAITLIN MOOREFIELD AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 6 E WILLOW GROVE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19118-3426
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Country | US
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Telephone | 267-459-9774
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Fax |
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Provider Business Mailing Address
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Address Line | 532 OLD MARLTON PIKE W #505
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City | MARLTON
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State | NJ
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Zip | 08053
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Country | US
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Telephone | 908-670-4908
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | SP036352
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License Number State | PA
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