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General NPI Number Information
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NPI Number | 1285202028
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Entity Type | Individual
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Provider Name | CAITLIN JEAN GREENE NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/17/2021
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 901 S HAVERHILL RD
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City | EL DORADO
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State | KS
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Zip | 67042-3225
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Country | US
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Telephone | 316-322-3371
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Fax |
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Provider Business Mailing Address
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Address Line | 588 NE COLE CREEK RD
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City | EL DORADO
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State | KS
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Zip | 67042-8536
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Country | US
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Telephone | 316-377-9337
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 53-80279-062
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-80279-062
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License Number State | KS
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