Provider Demographics
NPI:1205672086
Name:SUTTLE, CALEY (LPN)
Entity type:Individual
Prefix:MRS
First Name:CALEY
Middle Name:
Last Name:SUTTLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 BLENNERHASSETT AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-2272
Mailing Address - Country:US
Mailing Address - Phone:304-580-9411
Mailing Address - Fax:
Practice Address - Street 1:425 JULIANA ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-5352
Practice Address - Country:US
Practice Address - Phone:304-893-9777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-10-10
Deactivation Date:2024-07-02
Deactivation Code:
Reactivation Date:2024-10-10
Provider Licenses
StateLicense IDTaxonomies
WV38191164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse