Individual
KAITLYN SHANNON MACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 PAGE DR STE 8, PINEHURST, NC 28374-8847
(910) 621-2937
Mailing address
1910 SUTPHIN RD, SANFORD, NC 27330-7629
(910) 621-2937
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
96867
NC
Other
Enumeration date
03/10/2026
Last updated
03/10/2026
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