MEDICARE: KAITLYN MCFARLANE NP

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
1	363LP0222X	Critical Care Pediatric Nurse Practitioner	5013074	NC

General Provider Information

NPI Number	:	1568081123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN MCFARLANE NP

Provider Business Mailing Address
First Line	:	1142 FOLKSTONE RIDGE LN
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27127-6077
Country	:	US
Telephone Number	:	585-208-1537
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 MEDICAL CTR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27157-0001
Country	:	US
Telephone Number	:	336-713-6020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2020
Last Update Date	:	04/14/2020

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