Provider Demographics
NPI:1720762636
Name:MACDONALD, CAITLIN RUTH (FNP-C)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:RUTH
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:77 DANIEL WEBSTER HWY
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NH
Practice Address - Zip Code:03220-3028
Practice Address - Country:US
Practice Address - Phone:603-737-0550
Practice Address - Fax:603-737-8331
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH084018-21163W00000X
NH084018-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse