Provider Demographics
NPI:1750867958
Name:FILLIOE, CAITLIN (FNP)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:FILLIOE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 GREENBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-2139
Mailing Address - Country:US
Mailing Address - Phone:240-925-7514
Mailing Address - Fax:
Practice Address - Street 1:2054 S GREEN RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4243
Practice Address - Country:US
Practice Address - Phone:216-291-9210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF343273363LF0000X
OHAPRN.CNP.0027704363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily