Individual
KAYLEEN MAAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6019 OLEANDER DR, WILMINGTON, NC 28403-4796
(910) 332-3800
Mailing address
16602 GRAHAM PL, HUNTINGTON BEACH, CA 92649-3619
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12784
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2022
Last updated
12/09/2022
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