Individual
KATIE R CACCIAPALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(478) 633-2147
(478) 742-9670
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4704296775
MI
367500000X
Certified Registered Nurse Anesthetist
ARNP9301121
FL
367H00000X
Anesthesiologist Assistant
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704296775
MI LICENSE
MI
Enumeration date
07/18/2012
Last updated
10/17/2017
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