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General NPI Number Information
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NPI Number | 1801719109
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Entity Type | Individual
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Provider Name | CAITLYN DEANNA WALSH FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 1900 TEBEAU ST
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City | WAYCROSS
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State | GA
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Zip | 31501-6357
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Country | US
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Telephone | 912-283-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 5020 OLD RIVER RD
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City | BLACKSHEAR
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State | GA
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Zip | 31516-4184
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | APRN-NP261222
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License Number State | GA
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