Provider Demographics
NPI:1619517752
Name:WHITE, CAITLIN JANELL (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:JANELL
Last Name:WHITE
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:MS
Other - First Name:CAITLIN
Other - Middle Name:JANELL
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:904 RUSSELL PKWY # 10553
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-7336
Mailing Address - Country:US
Mailing Address - Phone:727-412-4406
Mailing Address - Fax:
Practice Address - Street 1:904 RUSSELL PKWY # 10553
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-7336
Practice Address - Country:US
Practice Address - Phone:727-412-4406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005628363LF0000X
GARN9382455363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily