Individual
KAITLIN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
122 12TH ST, PRINCETON, WV 24740-2312
(304) 487-7000
Mailing address
608 NEW HOPE RD STE 1, PRINCETON, WV 24740-2287
(304) 425-1522
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
105447
WV
Other
Enumeration date
03/06/2020
Last updated
03/06/2020
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