Healthcare Provider Details

I. General information

NPI: 1487438370
Provider Name (Legal Business Name): CAITLIN MARIE HANDWERK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 W NEWPORT RD
LITITZ PA
17543-7774
US

IV. Provider business mailing address

80 FIELDCREST DR
PALMYRA PA
17078-9142
US

V. Phone/Fax

Practice location:
  • Phone: 717-627-2108
  • Fax:
Mailing address:
  • Phone: 607-742-7089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberSP028041
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: