Provider Demographics
NPI:1326457953
Name:BUS, CAITLIN MARIE (RD)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MARIE
Last Name:BUS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:MARIE
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:850 HARVARD WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2055
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:10085 DOUBLE R BLVD
Practice Address - Street 2:STE 205
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5860
Practice Address - Country:US
Practice Address - Phone:775-982-5073
Practice Address - Fax:775-982-3958
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1068428133V00000X
NV37863DI-0133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
13554213OtherCAQH
AZ1068428OtherREGISTERED DIETITAIN
13554213OtherCAQH