Individual
KAITLYN STAVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 BOWMAN DR STE E366, VOORHEES, NJ 08043-9639
(856) 247-7295
(856) 247-7118
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 247-7295
(856) 247-7118
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP01001700
NJ
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/08/2025
Last updated
05/08/2026
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