Provider Demographics
NPI:1598003899
Name:VAN WHY, CAITLIN JEAN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:JEAN
Last Name:VAN WHY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:DEES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1507 E BRAINERD ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-6039
Mailing Address - Country:US
Mailing Address - Phone:281-221-3882
Mailing Address - Fax:
Practice Address - Street 1:5153 N 9TH AVE STE 302
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-5719
Practice Address - Country:US
Practice Address - Phone:850-416-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA-877363A00000X
FLPA9107820363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant