Individual
KAITLIN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
30 LACRUE AVE STE 101, GLEN MILLS, PA 19342-1042
(610) 558-4800
Mailing address
30 LACRUE AVE STE 101, GLEN MILLS, PA 19342-1042
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP029979
PA
363LG0600X
Gerontology Nurse Practitioner
SP029979
PA
Other
Enumeration date
06/28/2024
Last updated
08/08/2024
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