Provider Demographics
NPI:1700418514
Name:REGISTER, CAITLYN CHRISTINE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:CHRISTINE
Last Name:REGISTER
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3569 JOHNSON RD SE
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31606-9620
Mailing Address - Country:US
Mailing Address - Phone:229-630-4234
Mailing Address - Fax:
Practice Address - Street 1:2412 N OAK ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2567
Practice Address - Country:US
Practice Address - Phone:229-244-1400
Practice Address - Fax:229-244-5512
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN237721363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN237721OtherGEORGIA BOARD OF NURSING