Provider Demographics
NPI:1336465160
Name:CALDWELL, MICHELE LYN (APRN)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:LYN
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1783 GEORGIA RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-7319
Mailing Address - Country:US
Mailing Address - Phone:828-332-4218
Mailing Address - Fax:
Practice Address - Street 1:1783 GEORGIA RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-7319
Practice Address - Country:US
Practice Address - Phone:850-902-6045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9166841363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY07JUOtherBCBS
FL002015900Medicaid
FLDP910UOtherMEDICARE PTAN