Provider Demographics
NPI:1922417583
Name:CALDWELL, GLORIA D'LAINE (MS, RN, WHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:D'LAINE
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:MS, RN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 N HARRIS ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30601-2411
Mailing Address - Country:US
Mailing Address - Phone:706-389-6921
Mailing Address - Fax:706-389-6903
Practice Address - Street 1:345 N HARRIS ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-2411
Practice Address - Country:US
Practice Address - Phone:706-389-6921
Practice Address - Fax:706-389-6903
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN233046363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health