Provider Demographics
NPI:1629465166
Name:GARNER, CAITLYN MARY (MS, RDN)
Entity Type:Individual
Prefix:MRS
First Name:CAITLYN
Middle Name:MARY
Last Name:GARNER
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 QUAIL HAVEN DR APT D
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5664
Mailing Address - Country:US
Mailing Address - Phone:740-358-3964
Mailing Address - Fax:
Practice Address - Street 1:1805 JOHNSTOWN UTICA RD NW
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:OH
Practice Address - Zip Code:43080-9528
Practice Address - Country:US
Practice Address - Phone:740-358-3964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer