Individual
KAITLIN SOUTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805
Mailing address
19 TACOMA ST, WORCESTER, MA 01605-3516
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2308174
MA
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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