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NPI Code Detail

MEDICARE: MRS. KAITLIN EARLE FNP-C

MEDICARE: MRS. KAITLIN EARLE FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner110645WV

General Provider Information

NPI Number : 1396499802
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAITLIN EARLE FNP-C
Provider Business Mailing Address
First Line : 100 STONEY HILL RD
Second Line :
City : FAIRMONT
State : WV
Zip : 26554-1589
Country : US
Telephone Number : 304-333-8840
Fax Number :
Provider Business Practice Location Address
First Line : 100 STONEY HILL RD
Second Line :
City : FAIRMONT
State : WV
Zip : 26554-1589
Country : US
Telephone Number : 304-333-8840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2022
Last Update Date : 02/04/2022

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Directions to “ MRS. KAITLIN EARLE FNP-C” Practice Location

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