Provider Demographics
NPI:1730488834
Name:YENTER, CAITLIN MARIE SHANNON (DNP, AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MARIE SHANNON
Last Name:YENTER
Suffix:
Gender:F
Credentials:DNP, AGPCNP-BC
Other - Prefix:MS
Other - First Name:CAITLIN
Other - Middle Name:MARIE
Other - Last Name:SHANNON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:4100 STATE HWY 66
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-5703
Mailing Address - Country:US
Mailing Address - Phone:715-343-7700
Mailing Address - Fax:
Practice Address - Street 1:4100 STATE HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54482-8410
Practice Address - Country:US
Practice Address - Phone:715-847-3223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI174529-30163W00000X
WI6548-33363LA2200X, 363LG0600X
WI6548363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology