Provider Demographics
NPI:1205468238
Name:WALKER, CAITLIN SHEA (NP-C)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:SHEA
Last Name:WALKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:SHEA
Other - Last Name:BUMBLEDARE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1412 ADAMS FARM PKWY APT F
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-5131
Mailing Address - Country:US
Mailing Address - Phone:614-638-6517
Mailing Address - Fax:
Practice Address - Street 1:542 WHITE OAK ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-4772
Practice Address - Country:US
Practice Address - Phone:336-610-3720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF01201734363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily