Healthcare Provider Details

I. General information

NPI: 1871598961
Provider Name (Legal Business Name): GAYLA SUE CAULDWELL ARNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 SPRING HILL RD STE 450
VIENNA VA
22182-7509
US

IV. Provider business mailing address

3251 OLD LEE HWY STE 200
FAIRFAX VA
22030-1504
US

V. Phone/Fax

Practice location:
  • Phone: 703-270-4300
  • Fax: 703-270-4350
Mailing address:
  • Phone: 778-684-8278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0024164471
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number0001171562
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: