MEDICARE: CAITLIN CALKINS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	RN228147	GA

General Provider Information

NPI Number	:	1164948550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN CALKINS NP

Provider Business Mailing Address
First Line	:	2835 BRANDYWINE RD STE 400
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-5540
Country	:	US
Telephone Number	:	404-256-2593
Fax Number	:	770-488-9408

Provider Business Practice Location Address
First Line	:	1405 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1605
Country	:	US
Telephone Number	:	404-256-2593
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2017
Last Update Date	:	01/26/2021

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