Provider Demographics
NPI:1457107294
Name:SHETLAND, CAITLYN ANN (BS)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:ANN
Last Name:SHETLAND
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 BRIDGEPORT AVE APT D
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4173
Mailing Address - Country:US
Mailing Address - Phone:860-917-8018
Mailing Address - Fax:
Practice Address - Street 1:330 ORCHARD ST STE 107
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4430
Practice Address - Country:US
Practice Address - Phone:203-200-4362
Practice Address - Fax:203-200-1362
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator