Provider Demographics
NPI:1588314603
Name:DULANEY, CAITLYN MANNING
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:MANNING
Last Name:DULANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W FOREST AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-3940
Mailing Address - Country:US
Mailing Address - Phone:731-941-9490
Mailing Address - Fax:
Practice Address - Street 1:700 W FOREST AVE STE 200
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3940
Practice Address - Country:US
Practice Address - Phone:731-541-9490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.1959363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical