Healthcare Provider Details

I. General information

NPI: 1285246132
Provider Name (Legal Business Name): CAITLIN N LANDER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 FOREST AVE
ZANESVILLE OH
43701-2868
US

IV. Provider business mailing address

200 N MAYSVILLE AVE
ZANESVILLE OH
43701-6172
US

V. Phone/Fax

Practice location:
  • Phone: 740-450-1687
  • Fax: 740-450-1693
Mailing address:
  • Phone: 740-455-3112
  • Fax: 740-454-1363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0027388
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: