Individual
KAITLIN BRIANNA MITTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
742 JAMES ST, SYRACUSE, NY 13203-2017
(315) 703-2700
Mailing address
742 JAMES ST, SYRACUSE, NY 13203-2017
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
751604
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F406133-01
NY
Other
Enumeration date
02/07/2024
Last updated
08/08/2024
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