Healthcare Provider Details

I. General information

NPI: 1679136535
Provider Name (Legal Business Name): KAITLIN CAISON NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 MOORE ST
OXFORD GA
30054
US

IV. Provider business mailing address

104 MOORE ST
OXFORD GA
30054
US

V. Phone/Fax

Practice location:
  • Phone: 770-784-8376
  • Fax:
Mailing address:
  • Phone: 770-784-8376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN272355
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: