Provider Demographics
NPI:1710440250
Name:WESTMAN, CAITLIN
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:WESTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 204
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MN
Mailing Address - Zip Code:55056-0204
Mailing Address - Country:US
Mailing Address - Phone:715-417-4442
Mailing Address - Fax:651-243-5138
Practice Address - Street 1:66247 HAMALINE RD
Practice Address - Street 2:
Practice Address - City:FINLAYSON
Practice Address - State:MN
Practice Address - Zip Code:55735-4066
Practice Address - Country:US
Practice Address - Phone:715-417-4442
Practice Address - Fax:651-243-5138
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1095504374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide