Individual
DR. KELLY LYNNE CATINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1857
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093MK
BCBS PROV #
NC
01
—
410049391
RR MEDICARE INDIVIDUAL #
NC
01
—
410049393
RR MEDICARE INDIVIDUAL #
NC
05
—
89093MK
—
NC
Enumeration date
08/02/2005
Last updated
07/06/2020
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