Healthcare Provider Details

I. General information

NPI: 1992614465
Provider Name (Legal Business Name): CAITLIN YOUNG POLLARD DHSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W 21ST ST
CLOVIS NM
88101-4151
US

IV. Provider business mailing address

1843 PELICAN LN
NAVARRE FL
32566-8517
US

V. Phone/Fax

Practice location:
  • Phone: 575-769-2345
  • Fax:
Mailing address:
  • Phone: 910-429-5059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: