Provider Demographics
NPI:1639680770
Name:POWERS, CAITLIN NICHOLE (APRN)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:NICHOLE
Last Name:POWERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:NICHOLE
Other - Last Name:HATCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 HARBOR APPROACH
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-3148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:259 N PETERS RD STE 103
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4923
Practice Address - Country:US
Practice Address - Phone:865-690-1255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000023242363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily