Provider Demographics
NPI:1932093135
Name:PETERS, CAITLIN ANNE (CP)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ANNE
Last Name:PETERS
Suffix:
Gender:F
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 N FANT ST STE A
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5705
Mailing Address - Country:US
Mailing Address - Phone:864-622-0900
Mailing Address - Fax:
Practice Address - Street 1:6 OLD GROVE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4769
Practice Address - Country:US
Practice Address - Phone:864-552-9772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXCP004629224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist