Healthcare Provider Details

I. General information

NPI: 1194661843
Provider Name (Legal Business Name): CAITLIN PADON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4560 GUADALUPE CHURCH ST NW UNIT 703
ALBUQUERQUE NM
87107-3177
US

IV. Provider business mailing address

4560 GUADALUPE CHURCH ST NW UNIT 703
ALBUQUERQUE NM
87107-3177
US

V. Phone/Fax

Practice location:
  • Phone: 509-714-2447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number89709
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: