Provider Demographics
NPI:1568868180
Name:LEGEAY, CAITLIN E (PA-C)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:E
Last Name:LEGEAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:E
Other - Last Name:OWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1104 33RD AVE NORTH
Mailing Address - Street 2:BUILDING A
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209
Mailing Address - Country:US
Mailing Address - Phone:270-792-7741
Mailing Address - Fax:
Practice Address - Street 1:719 THOMPSON LANE
Practice Address - Street 2:SUITE 23108
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204
Practice Address - Country:US
Practice Address - Phone:615-936-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2720363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant