Provider Demographics
NPI:1083326391
Name:ELLINGER, CAITLIN N (LPN)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:N
Last Name:ELLINGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 N PROGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9100
Mailing Address - Country:US
Mailing Address - Phone:717-233-7290
Mailing Address - Fax:717-810-1841
Practice Address - Street 1:3601 N PROGRESS AVE
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9100
Practice Address - Country:US
Practice Address - Phone:717-233-7290
Practice Address - Fax:717-810-1841
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN302890164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse