Provider Demographics
NPI:1245599513
Name:MENGLER, CAITLIN L (FNP)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:L
Last Name:MENGLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9313 MEDICAL PLAZA DR STE 103
Mailing Address - Street 2:
Mailing Address - City:N CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9802
Mailing Address - Country:US
Mailing Address - Phone:843-790-8280
Mailing Address - Fax:843-974-8500
Practice Address - Street 1:9313 MEDICAL PLAZA DR STE 103
Practice Address - Street 2:
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9802
Practice Address - Country:US
Practice Address - Phone:843-790-8280
Practice Address - Fax:843-974-8500
Is Sole Proprietor?:No
Enumeration Date:2012-05-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17836363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2055Medicaid