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General NPI Number Information
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NPI Number | 1861143125
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Entity Type | Individual
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Provider Name | KAITLIN SAULTS PA
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Gender | Female
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 3652 MAHAN DR
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5626
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Country | US
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Telephone | 850-329-8429
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Fax |
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Provider Business Mailing Address
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Address Line | 2131 E DELLVIEW DR
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City | TALLAHASSEE
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State | FL
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Zip | 32303-4866
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Country | US
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Telephone | 850-241-6018
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9115494
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License Number State | FL
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