Provider Demographics
NPI:1508424631
Name:MYERS, CAITLIN NICOLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:NICOLE
Last Name:MYERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:NICOLE
Other - Last Name:HENDRICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4324 N RUSHWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:BEL AIRE
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1488
Mailing Address - Country:US
Mailing Address - Phone:316-516-2869
Mailing Address - Fax:
Practice Address - Street 1:4324 N RUSHWOOD CIR
Practice Address - Street 2:
Practice Address - City:BEL AIRE
Practice Address - State:KS
Practice Address - Zip Code:67226-1488
Practice Address - Country:US
Practice Address - Phone:316-516-2869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical