Healthcare Provider Details

I. General information

NPI: 1346795358
Provider Name (Legal Business Name): CAITLIN MAUREEN OLOHAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 CAMPUS DRIVE
COLLEGE PARK MD
20742-0001
US

IV. Provider business mailing address

140 CAMPUS DRIVE
COLLEGE PARK MD
20742-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-314-8184
  • Fax:
Mailing address:
  • Phone: 301-314-8184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR209859
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: