Provider Demographics
NPI:1043795859
Name:CALDWELL, CHIQUINTA L (BSN RN-BC)
Entity Type:Individual
Prefix:
First Name:CHIQUINTA
Middle Name:L
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:BSN RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 RIDGEDALE DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-3322
Mailing Address - Country:US
Mailing Address - Phone:870-500-5433
Mailing Address - Fax:
Practice Address - Street 1:514 RIDGEDALE DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-3322
Practice Address - Country:US
Practice Address - Phone:870-500-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX881452163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse