Provider Demographics
NPI:1992195614
Name:NUTT, CAITLYN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CAITLYN
Middle Name:
Last Name:NUTT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15922 CRAIN HWY
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-8047
Mailing Address - Country:US
Mailing Address - Phone:301-720-9001
Mailing Address - Fax:301-720-9011
Practice Address - Street 1:15922 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-8047
Practice Address - Country:US
Practice Address - Phone:301-720-9001
Practice Address - Fax:301-720-9011
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19755183500000X
DEA1-0004170183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist