Individual
MISS KAITLYN ROSE CARRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
631 S COLLEGE AVE, NEWARK, DE 19716-2010
(279) 230-2831
Mailing address
10 REGAL DR, MONMOUTH JUNCTION, NJ 08852-3046
(732) 823-2008
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
YHQ3HZN08970530
HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY
—
Enumeration date
06/07/2022
Last updated
06/07/2022
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