Provider Demographics
NPI:1316610819
Name:FANNIN, CAITLYN SCHLIE (CNP)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:SCHLIE
Last Name:FANNIN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:MARIE
Other - Last Name:SCHLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2845 PROGRESS WAY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-7704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2845 PROGRESS WAY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-7704
Practice Address - Country:US
Practice Address - Phone:937-366-1082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029007363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily