Healthcare Provider Details

I. General information

NPI: 1336012293
Provider Name (Legal Business Name): CAITLEN MURRELL CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4830 ANDRADE
PENSACOLA FL
32504-9020
US

IV. Provider business mailing address

4830 ANDRADE
PENSACOLA FL
32504-9020
US

V. Phone/Fax

Practice location:
  • Phone: 850-503-2112
  • Fax:
Mailing address:
  • Phone: 850-503-2112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number201741
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: