Provider Demographics
NPI:1093584872
Name:MADDEN, KAITLYN ANN (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:ANN
Last Name:MADDEN
Suffix:
Gender:
Credentials:PHYSICIAN ASSISTANT
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5105
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-5100
Mailing Address - Country:US
Mailing Address - Phone:610-636-0405
Mailing Address - Fax:
Practice Address - Street 1:5160 OCEAN HWY W
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-4012
Practice Address - Country:US
Practice Address - Phone:910-332-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-21
Last Update Date:2025-03-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant