Provider Demographics
NPI:1245770130
Name:DEMING, CAITLYN (ARNP)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:DEMING
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 VIA LUGANO CIR
Mailing Address - Street 2:APT 204
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-7161
Mailing Address - Country:US
Mailing Address - Phone:561-291-4218
Mailing Address - Fax:
Practice Address - Street 1:2900 N MILITARY TRL
Practice Address - Street 2:SUITE 245
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6365
Practice Address - Country:US
Practice Address - Phone:561-994-2007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9361429363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily