Provider Demographics
NPI:1053663252
Name:WEIHRAUCH, CAITLIN THERESE (CRNA)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:THERESE
Last Name:WEIHRAUCH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:THERESE
Other - Last Name:TARASAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5721 CREEK PARK DR
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-5202
Mailing Address - Country:US
Mailing Address - Phone:763-443-3389
Mailing Address - Fax:
Practice Address - Street 1:6401 FRANCE AVE S
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2104
Practice Address - Country:US
Practice Address - Phone:952-924-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1611715163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse