Provider Demographics
NPI:1225666407
Name:ARBOUR, KAITLYN ANN (MD, MPH, MS)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:ANN
Last Name:ARBOUR
Suffix:
Gender:F
Credentials:MD, MPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 E HOSPITAL DR SPC 4254
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-4254
Mailing Address - Country:US
Mailing Address - Phone:734-763-4109
Mailing Address - Fax:
Practice Address - Street 1:1540 E HOSPITAL DR SPC 4254
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-4254
Practice Address - Country:US
Practice Address - Phone:734-763-4109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43015113252080N0001X
TXU3144208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine