Healthcare Provider Details

I. General information

NPI: 1275215022
Provider Name (Legal Business Name): CAITLIN B PERRY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 N 2ND ST
ATCHISON KS
66002-1203
US

IV. Provider business mailing address

1412 N 2ND ST
ATCHISON KS
66002-1203
US

V. Phone/Fax

Practice location:
  • Phone: 913-367-4879
  • Fax: 913-367-0240
Mailing address:
  • Phone: 913-367-4879
  • Fax: 913-367-0240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-82368
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: