Healthcare Provider Details

I. General information

NPI: 1992427108
Provider Name (Legal Business Name): CAITLYN GRIFFIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2022
Last Update Date: 09/14/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 14TH ST
BURLINGTON CO
80807-1609
US

IV. Provider business mailing address

451 14TH ST
BURLINGTON CO
80807-1609
US

V. Phone/Fax

Practice location:
  • Phone: 719-345-4681
  • Fax:
Mailing address:
  • Phone: 719-346-4681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0998002-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: