Provider Demographics
NPI:1770522591
Name:CALDWELL, MARCIA ANN (ARNP,CRNA)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:ANN
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:ARNP,CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 MUSTANG CREEK NORTH LOOP
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-3440
Mailing Address - Country:US
Mailing Address - Phone:321-243-9291
Mailing Address - Fax:
Practice Address - Street 1:155 MUSTANG CREEK NORTH LOOP
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-3440
Practice Address - Country:US
Practice Address - Phone:321-243-9291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1500382174400000X
FL031030367500000X
IN28057735A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No174400000XOther Service ProvidersSpecialist