Individual
KAITLYN MARIE HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
315 SUSQUEHANNA ST, JOHNSTOWN, PA 15905-1852
(814) 525-8496
Mailing address
315 SUSQUEHANNA ST, JOHNSTOWN, PA 15905-1852
(814) 525-8496
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
SP027551
PA
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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