Provider Demographics
NPI:1609175223
Name:CASPERSON, CAITLYN (RN)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:CASPERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6411 N. ROBERT RD., RM 416
Mailing Address - Street 2:HUMBOLDT UNIFIED SCHOOL DISTRICT
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314
Mailing Address - Country:US
Mailing Address - Phone:928-759-4042
Mailing Address - Fax:928-759-4030
Practice Address - Street 1:6411 N. ROBET RD., RM. 416
Practice Address - Street 2:HUMBOLDT UNIFIED SCHOOL DISTRICT
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314
Practice Address - Country:US
Practice Address - Phone:928-759-4042
Practice Address - Fax:928-759-4030
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN167584163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool