Basic Information
Provider Information
NPI: 1407360589
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARTHUR
FirstName: CAITLIN
MiddleName: ELIZABETH
NamePrefix: MRS.
NameSuffix:  
Credential: APRN, AGACNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 501 MORRIS ST STE 362
Address2:  
City: CHARLESTON
State: WV
PostalCode: 253011326
CountryCode: US
TelephoneNumber: 3043883574
FaxNumber: 3043886481
Practice Location
Address1: 501 MORRIS ST STE 362
Address2:  
City: CHARLESTON
State: WV
PostalCode: 253011326
CountryCode: US
TelephoneNumber: 3043883574
FaxNumber: 3043886481
Other Information
ProviderEnumerationDate: 11/28/2017
LastUpdateDate: 01/09/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LG0600XAPRN83345-AGACNP-BCWVY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology

No ID Information.


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