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General NPI Number Information
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NPI Number | 1124688676
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Entity Type | Individual
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Provider Name | CAITLIN O'LEARY ELLIOTT FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/17/2019
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 463 W SAM RIDLEY PKWY
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City | SMYRNA
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State | TN
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Zip | 37167-5626
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Country | US
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Telephone | 615-768-4258
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Fax | 615-768-4259
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Provider Business Mailing Address
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Address Line | PO BOX 932958
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City | CLEVELAND
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State | OH
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Zip | 44193-0028
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 25719
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License Number State | TN
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