Basic Information
| Provider Information | |||||||||
| NPI: | 1316565666 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | CAITLIN | ||||||||
| MiddleName: | JO | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 526 SWEET BIRCH CT | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421017557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176946553 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 20TH AVE NORTH | ||||||||
| Address2: | G-4 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152845098 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2020 | ||||||||
| LastUpdateDate: | 07/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 3014764 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.