Provider Demographics
NPI:1851984942
Name:WAUGH, CAITLYN RAE (LPN)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:RAE
Last Name:WAUGH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:RAE
Other - Last Name:BOWLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-0188
Mailing Address - Country:US
Mailing Address - Phone:740-773-4366
Mailing Address - Fax:740-773-4750
Practice Address - Street 1:8323 STATE ROUTE 7 N
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:OH
Practice Address - Zip Code:45620-9001
Practice Address - Country:US
Practice Address - Phone:740-992-2192
Practice Address - Fax:740-992-4018
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.177924.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse