Healthcare Provider Details

I. General information

NPI: 1275168965
Provider Name (Legal Business Name): CAITLIN NICOLE TAZI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAITLIN NICOLE WRIGHT

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 QUAKER LN # C2-4
WARWICK RI
02886-0159
US

IV. Provider business mailing address

PO BOX 746088
ATLANTA GA
30374-6088
US

V. Phone/Fax

Practice location:
  • Phone: 401-233-5051
  • Fax:
Mailing address:
  • Phone: 312-733-9730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN02262
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: