Healthcare Provider Details

I. General information

NPI: 1710770953
Provider Name (Legal Business Name): CAITLYN ANTHONY PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 HAWTHORN ST STE 4
DARTMOUTH MA
02747-3733
US

IV. Provider business mailing address

516 HAWTHORN ST STE 4
DARTMOUTH MA
02747-3733
US

V. Phone/Fax

Practice location:
  • Phone: 774-929-7420
  • Fax:
Mailing address:
  • Phone: 774-929-7420
  • Fax: 774-929-7420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2310617
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: