Basic Information
| Provider Information | |||||||||
| NPI: | 1487999827 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBERTS | ||||||||
| FirstName: | CAITLIN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19 DEPOT ST | ||||||||
| Address2: | |||||||||
| City: | ADAMS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 012201856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137431080 | ||||||||
| FaxNumber: | 4137435306 | ||||||||
| Practice Location | |||||||||
| Address1: | 19 DEPOT ST | ||||||||
| Address2: | |||||||||
| City: | ADAMS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 012201856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137431080 | ||||||||
| FaxNumber: | 4137435306 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2012 | ||||||||
| LastUpdateDate: | 04/07/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN2258449 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.