Individual
KAITLYN WALISIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
501 N ELAM AVE, GREENSBORO, NC 27403-1118
(336) 832-1100
Mailing address
PO BOX 10467, GREENSBORO, NC 27404-0467
(336) 207-7005
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-09367
NC
Other
Enumeration date
09/23/2019
Last updated
07/21/2022
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