Provider Demographics
NPI:1124688676
Name:ELLIOTT, CAITLIN O'LEARY (FNP-C)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:O'LEARY
Last Name:ELLIOTT
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 932958
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:463 W SAM RIDLEY PKWY
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5626
Practice Address - Country:US
Practice Address - Phone:615-768-4258
Practice Address - Fax:615-768-4259
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017373363LF0000X
TN25719363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3017373OtherADVANCED PRACTICE REGISTERED NURSE
F02190835OtherAANP CERTIFICATION
TN25719OtherADVANCED PRACTICE REGISTERED NURSE
TN179862OtherREGISTERED NURSE