Provider Demographics
NPI:1386068740
Name:COATES, CAITLYN (PA-C MPH)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:COATES
Suffix:
Gender:F
Credentials:PA-C MPH
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:14923 CHILGROVE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-9760
Mailing Address - Country:US
Mailing Address - Phone:919-796-7955
Mailing Address - Fax:
Practice Address - Street 1:2809 E MILLBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604
Practice Address - Country:US
Practice Address - Phone:919-790-3237
Practice Address - Fax:919-790-3268
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-04821363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant