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Individual

CAITLIN ONTIVEROS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
7210 VILLAGE MEDICAL CIR STE 310, CLEMMONS, NC 27012-8041
(336) 277-4075
(336) 277-4070
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 277-4075
(336) 277-4070

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-14694
NC
363AM0700X
Medical Physician Assistant
363AS0400X
Surgical Physician Assistant

Other

Enumeration date
07/27/2023
Last updated
02/24/2026
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