Individual
KAITLIN CLARK OSBOURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10660 PARK RD, STE 3400, CHARLOTTE, NC 28210-8413
(704) 667-1540
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
0010-03194
NC
363A00000X
Physician Assistant
0010-03194
NC
Other
Enumeration date
10/25/2011
Last updated
07/24/2024
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