Provider Demographics
NPI:1306627955
Name:CROTTY, CAITLIN (DNP)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:CROTTY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32330 PEREGRINE WAY
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:DE
Mailing Address - Zip Code:19970-3696
Mailing Address - Country:US
Mailing Address - Phone:717-395-1990
Mailing Address - Fax:
Practice Address - Street 1:32550 DOCS PL
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:DE
Practice Address - Zip Code:19967-6975
Practice Address - Country:US
Practice Address - Phone:302-541-4175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0012361363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily