Provider Demographics
NPI:1598394876
Name:WALTERS, CAITLYN (DO)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:WALTERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8467 VACAREZ DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-4711
Mailing Address - Country:US
Mailing Address - Phone:304-444-4443
Mailing Address - Fax:
Practice Address - Street 1:6900 N DURANGO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4409
Practice Address - Country:US
Practice Address - Phone:702-835-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO3423208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist