Individual
KAITLIN CRANE MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
201 SAINT ANN DR, MANDEVILLE, LA 70471-3471
(985) 898-4001
Mailing address
201 SAINT ANN DR, MANDEVILLE, LA 70471-3471
(985) 898-4001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
338520
LA
207Q00000X
Family Medicine Physician
LL83967
SC
390200000X
Student in an Organized Health Care Education/Training Program
83967
SC
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/23/2020
Last updated
09/20/2023
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