Provider Demographics
NPI:1225697261
Name:CAPUTO, NICHOLAS (MSN, APRN-CNP)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:
Last Name:CAPUTO
Suffix:
Gender:M
Credentials:MSN, APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 S BURNETT RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-2604
Mailing Address - Country:US
Mailing Address - Phone:937-525-2470
Mailing Address - Fax:937-525-2432
Practice Address - Street 1:362 S BURNETT RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-2604
Practice Address - Country:US
Practice Address - Phone:937-525-2470
Practice Address - Fax:937-525-2432
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH024788363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty