Provider Demographics
NPI:1780481614
Name:GRANT, KAITLIN (RN, BSN)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:GRANT
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:
Other - Last Name:CATALDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:404 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-2110
Mailing Address - Country:US
Mailing Address - Phone:315-725-5975
Mailing Address - Fax:
Practice Address - Street 1:2300 WINDY RIDGE PKWY SE STE 850S
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-8611
Practice Address - Country:US
Practice Address - Phone:929-376-0056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY712388163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice