Healthcare Provider Details

I. General information

NPI: 1811626054
Provider Name (Legal Business Name): CAITLIN WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2022
Last Update Date: 06/05/2022
Certification Date: 06/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8336 W WOODARD DR
LAKEWOOD CO
80227-2446
US

IV. Provider business mailing address

8336 W WOODARD DR
LAKEWOOD CO
80227-2446
US

V. Phone/Fax

Practice location:
  • Phone: 720-394-5809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number14445523CW
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: