Healthcare Provider Details

I. General information

NPI: 1710394572
Provider Name (Legal Business Name): CAITLIN SCHUH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 08/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 JACKSON AVE
TACOMA WA
98431-7324
US

IV. Provider business mailing address

1501 MICAHS WAY N
SPRING LAKE NC
28390-2863
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-3885
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number2016
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: