Provider Demographics
NPI:1689422529
Name:CAUDILL, ERIN JEWEL
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:JEWEL
Last Name:CAUDILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 GROVE RUN RD
Mailing Address - Street 2:
Mailing Address - City:COMMERCIAL POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43116-9707
Mailing Address - Country:US
Mailing Address - Phone:614-593-2374
Mailing Address - Fax:
Practice Address - Street 1:133 GROVE RUN RD
Practice Address - Street 2:
Practice Address - City:COMMERCIAL POINT
Practice Address - State:OH
Practice Address - Zip Code:43116-9707
Practice Address - Country:US
Practice Address - Phone:614-593-2374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHVE541075376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker