Provider Demographics
NPI:1902153133
Name:MADISON, CAITLIN H (CNM)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:H
Last Name:MADISON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:ELIZABETH
Other - Last Name:HANRAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 EUCLID AVE STE 30
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-3617
Mailing Address - Country:US
Mailing Address - Phone:888-874-3752
Mailing Address - Fax:
Practice Address - Street 1:220 EUCLID AVE STE 30
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-3617
Practice Address - Country:US
Practice Address - Phone:888-874-3752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMW010283367A00000X
PAMW010283367A00000X
CANMW236145176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife