Provider Demographics
NPI:1558248120
Name:VASQUEZ, CAROLINE LOUISE (FNP)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:LOUISE
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:CAROLINE
Other - Middle Name:L
Other - Last Name:CALDWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:146 ROLENSTRO RD
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39817-7433
Mailing Address - Country:US
Mailing Address - Phone:786-282-2889
Mailing Address - Fax:
Practice Address - Street 1:146 ROLENSTRO RD
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39817-7433
Practice Address - Country:US
Practice Address - Phone:786-282-2889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11041435208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice