Individual
CAITLIN ELIZABETH NILSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
11501 N 79TH AVE, PEORIA, AZ 85345-1358
(623) 412-4453
Mailing address
11501 N 79TH AVE, PEORIA, AZ 85345-1358
(623) 412-4453
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP054538
AZ
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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