Healthcare Provider Details

I. General information

NPI: 1558730093
Provider Name (Legal Business Name): CAITLYN MARIE SLINGLUFF ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAITLYN MARIE VANWIE ATC

II. Dates (important events)

Enumeration Date: 09/15/2015
Last Update Date: 07/24/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S. CATON AVENUE
BALTIMORE MD
21229
US

IV. Provider business mailing address

900 S. CATON AVENUE
BALTIMORE MD
21229
US

V. Phone/Fax

Practice location:
  • Phone: 667-234-6000
  • Fax: 410-368-9997
Mailing address:
  • Phone: 667-234-6000
  • Fax: 410-368-9997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberA0001523
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT002783
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: