Provider Demographics
NPI:1679015879
Name:POWERS, CAITLIN ELISABETH (PA)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ELISABETH
Last Name:POWERS
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:78 GOSLING CIR APT A02
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2396
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:78 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2332
Practice Address - Country:US
Practice Address - Phone:540-332-4423
Practice Address - Fax:540-332-5658
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-06
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110005655363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant