Individual
MS. KAITLIN JO WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5049 33RD AVE S, FARGO, ND 58104-7080
(701) 356-1001
Mailing address
4751 46TH ST S APT 311, FARGO, ND 58104-8969
(320) 287-1216
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R43377
ND
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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