Healthcare Provider Details

I. General information

NPI: 1215744750
Provider Name (Legal Business Name): CAITLYN LEE PARRISH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAITLYN FIELDS

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 12TH ST
COLUMBUS GA
31906-2938
US

IV. Provider business mailing address

7641 TIMBERDALE CT
COLUMBUS GA
31909-1776
US

V. Phone/Fax

Practice location:
  • Phone: 706-324-0471
  • Fax:
Mailing address:
  • Phone: 706-325-4777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberGAA-NP002960
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: