Provider Demographics
NPI:1417530775
Name:CUDAHY, KAITLIN ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:ELIZABETH
Last Name:CUDAHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:ELIZABETH
Other - Last Name:KUDLAC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:110 SINGER WAY
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5551
Mailing Address - Country:US
Mailing Address - Phone:512-656-0347
Mailing Address - Fax:
Practice Address - Street 1:6715 MCCRIMMON PKWY STE 300
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-1916
Practice Address - Country:US
Practice Address - Phone:919-481-4997
Practice Address - Fax:984-215-4551
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC304805208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty