Healthcare Provider Details

I. General information

NPI: 1013694140
Provider Name (Legal Business Name): MS. CAITLIN E MYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 US HIGHWAY 70 BUS E
SMITHFIELD NC
27577-7790
US

IV. Provider business mailing address

10535 BEDFORDTOWN DR
RALEIGH NC
27614-8070
US

V. Phone/Fax

Practice location:
  • Phone: 919-934-6031
  • Fax:
Mailing address:
  • Phone: 919-325-6910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30002109
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: