Provider Demographics
NPI:1760208441
Name:WATERS, CAITLIN ELIZABETH (APRN-CNP)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ELIZABETH
Last Name:WATERS
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:106 W RAY FINE BOULEVARD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ROLAND
Mailing Address - State:OK
Mailing Address - Zip Code:74954
Mailing Address - Country:US
Mailing Address - Phone:918-571-4332
Mailing Address - Fax:918-571-4381
Practice Address - Street 1:106 W RAY FINE BOULEVARD
Practice Address - Street 2:SUITE 3
Practice Address - City:ROLAND
Practice Address - State:OK
Practice Address - Zip Code:74954
Practice Address - Country:US
Practice Address - Phone:918-571-4332
Practice Address - Fax:918-571-4381
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2025-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AR230935363LF0000X
OK217058363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily