Provider Demographics
NPI:1962126656
Name:BACHMAN, CAELEY
Entity type:Individual
Prefix:
First Name:CAELEY
Middle Name:
Last Name:BACHMAN
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 1:260 HOPE ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2258
Mailing Address - Country:US
Mailing Address - Phone:208-599-2452
Mailing Address - Fax:
Practice Address - Street 1:260 HOPE ST APT 2B
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2258
Practice Address - Country:US
Practice Address - Phone:208-599-2452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist