Individual
KAITLIN TORRES KOTNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-12096
NC
363A00000X
Physician Assistant
PA2017-0094
NM
363AS0400X
Surgical Physician Assistant
Primary
0010-12096
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861902835
—
NC
Enumeration date
10/04/2017
Last updated
09/28/2023
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