Healthcare Provider Details

I. General information

NPI: 1508783812
Provider Name (Legal Business Name): CAITLIN CHRISTENSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2174 N DRUID HILLS RD NE
ATLANTA GA
30329-3102
US

IV. Provider business mailing address

2174 N DRUID HILLS RD NE
ATLANTA GA
30329-3102
US

V. Phone/Fax

Practice location:
  • Phone: 404-785-5437
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN-NP711423
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberAPRN-NP711423
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: