Provider Demographics
NPI:1023538980
Name:STAVENS-MEUCCI, CAITLIN PAIGE (NNP)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:PAIGE
Last Name:STAVENS-MEUCCI
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:STAVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NNP
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:119 BELMONT ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2903
Practice Address - Country:US
Practice Address - Phone:508-334-6206
Practice Address - Fax:508-334-6083
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2312435363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal