Individual
CAITLIN DERENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(360) 606-4292
Mailing address
1123 WOODRIDGE DR APT 7, GRAFTON, WI 53024-1141
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8558-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100382769
—
WI
Enumeration date
09/02/2025
Last updated
12/05/2025
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