Provider Demographics
NPI:1922346659
Name:PALMISANO, CAITLIN (CRNP)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:PALMISANO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:HUDGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:713 E FORT AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4724
Mailing Address - Country:US
Mailing Address - Phone:410-299-5230
Mailing Address - Fax:
Practice Address - Street 1:1800 ORLEANS ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0010
Practice Address - Country:US
Practice Address - Phone:410-955-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2016-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR173668363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD066069800Medicaid
MDP01203507OtherRRMC
MD289433YUXMedicare PIN