Provider Demographics
NPI:1336826866
Name:BRAGA, CAITLYN ANN (NP)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:ANN
Last Name:BRAGA
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:ANN
Other - Last Name:THIBEAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ STE 400
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4752
Mailing Address - Country:US
Mailing Address - Phone:401-444-6779
Mailing Address - Fax:401-444-6912
Practice Address - Street 1:450 VETERANS MEMORIAL PKWY BLDG 6
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-5300
Practice Address - Country:US
Practice Address - Phone:401-435-5533
Practice Address - Fax:401-435-5522
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN04485363L00000X
MARN2295546163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner