Provider Demographics
NPI:1619794880
Name:STONE, CAITLIN MICHELE (LPN)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MICHELE
Last Name:STONE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 N RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-3147
Mailing Address - Country:US
Mailing Address - Phone:505-747-8259
Mailing Address - Fax:
Practice Address - Street 1:1227 N RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-3147
Practice Address - Country:US
Practice Address - Phone:505-747-8259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11070975164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse