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NPI Code Detail

MEDICARE: CAITLIN JEAN GREENE NP-C

MEDICARE: CAITLIN JEAN GREENE NP-C
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
1363L00000XNurse Practitioner53-80279-062KS
2363LF0000XFamily Nurse Practitioner53-80279-062KS

General Provider Information

NPI Number : 1285202028
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLIN JEAN GREENE NP-C
Provider Business Mailing Address
First Line : 588 NE COLE CREEK RD
Second Line :
City : EL DORADO
State : KS
Zip : 67042-8536
Country : US
Telephone Number : 316-377-9337
Fax Number :
Provider Business Practice Location Address
First Line : 901 S HAVERHILL RD
Second Line :
City : EL DORADO
State : KS
Zip : 67042-3225
Country : US
Telephone Number : 316-322-3371
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2021
Last Update Date : 01/27/2026

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Directions to “ CAITLIN JEAN GREENE NP-C” Practice Location

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