Healthcare Provider Details

I. General information

NPI: 1770023095
Provider Name (Legal Business Name): CAITLIN ROSE RAMIREZ BSN, RN, CNOR, RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2017
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

769 SW 19TH ST APT 13108
MOORE OK
73160-3046
US

IV. Provider business mailing address

769 SW 19TH ST APT 13108
MOORE OK
73160-3046
US

V. Phone/Fax

Practice location:
  • Phone: 760-819-9461
  • Fax:
Mailing address:
  • Phone: 760-819-9461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number99552
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number896282
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: