Provider Demographics
NPI:1558764548
Name:KRIEGER, CAITLIN ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:ELIZABETH
Last Name:KRIEGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:CAITLIN
Other - Middle Name:ELIZABETH
Other - Last Name:HURD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7229 WHEAT STREET NE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014
Mailing Address - Country:US
Mailing Address - Phone:678-625-5132
Mailing Address - Fax:678-625-5137
Practice Address - Street 1:7229 WHEAT STREET NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014
Practice Address - Country:US
Practice Address - Phone:678-625-5132
Practice Address - Fax:678-625-5137
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7235363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant