Provider Demographics
NPI:1952158404
Name:HERMES, KAETLIN (RN)
Entity type:Individual
Prefix:
First Name:KAETLIN
Middle Name:
Last Name:HERMES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KAETLIN
Other - Middle Name:
Other - Last Name:WENINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:11611 E ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:HAVEN
Mailing Address - State:KS
Mailing Address - Zip Code:67543-8044
Mailing Address - Country:US
Mailing Address - Phone:620-899-4843
Mailing Address - Fax:
Practice Address - Street 1:3965 HOLCOMB BRIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-2203
Practice Address - Country:US
Practice Address - Phone:770-450-8677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach