Provider Demographics
NPI:1982262309
Name:RADEMACHER, CAITLYN (NP)
Entity type:Individual
Prefix:MRS
First Name:CAITLYN
Middle Name:
Last Name:RADEMACHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:
Other - Last Name:FAHLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
Mailing Address - Street 2:SUITE J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:5333 MCAULEY DR
Practice Address - Street 2:SUITE 3001
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197
Practice Address - Country:US
Practice Address - Phone:734-712-8100
Practice Address - Fax:734-887-8942
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI470221666363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant