Provider Demographics
NPI:1093449407
Name:PIRTEL, KAITLYN DEBRA (CNM, RN, DNP)
Entity type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:DEBRA
Last Name:PIRTEL
Suffix:
Gender:F
Credentials:CNM, RN, DNP
Other - Prefix:MS
Other - First Name:KAITLYN
Other - Middle Name:DEBRA
Other - Last Name:FLAHERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 JOHN ST
Mailing Address - Street 2:UNIT 213
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852
Mailing Address - Country:US
Mailing Address - Phone:978-746-4210
Mailing Address - Fax:
Practice Address - Street 1:630 MIX AVE APT 5H
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-2345
Practice Address - Country:US
Practice Address - Phone:978-746-4210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT169473163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse