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NPI Code Detail

MEDICARE: MISS KAITLYN RENEE BIRCH

MEDICARE: MISS KAITLYN RENEE BIRCH
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
1390200000XStudent in an Organized Health Care Education/Training Program
22255A2300XAthletic Trainer

General Provider Information

NPI Number : 1629571179
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KAITLYN RENEE BIRCH
Provider Business Mailing Address
First Line : 17626 HOOPER RD
Second Line :
City : GREENWELL SPRINGS
State : LA
Zip : 70739-5743
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 W UNIVERSITY AVE
Second Line :
City : HAMMOND
State : LA
Zip : 70401-1304
Country : US
Telephone Number : 985-549-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2018
Last Update Date : 03/12/2018

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Directions to “ MISS KAITLYN RENEE BIRCH ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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