Individual
KAITLIN REISS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CPNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
225342
SC
363LP0200X
Pediatric Nurse Practitioner
21374
SC
363LP0200X
Pediatric Nurse Practitioner
Primary
95012201
CA
Other
Enumeration date
10/30/2014
Last updated
03/18/2021
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