Provider Demographics
NPI:1902797079
Name:SEQUIN, KAITLYN ELIZABETH (OD)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:ELIZABETH
Last Name:SEQUIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3285 SCHUST RD # APPT208
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-8101
Mailing Address - Country:US
Mailing Address - Phone:989-778-0352
Mailing Address - Fax:
Practice Address - Street 1:3275 TITTABAWASSEE RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9436
Practice Address - Country:US
Practice Address - Phone:989-399-3477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005880152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist