Provider Demographics
NPI:1174001614
Name:CLARKIN, CAITLIN M (PA-C)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:M
Last Name:CLARKIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1155 MILL STREET M14
Mailing Address - Street 2:RENOWN MEDICAL GROUP HEMATOLOGY/ONCOLOGY
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-8400
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-3900
Practice Address - Street 1:75 PRINGLE WAY STE 801
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-8400
Practice Address - Country:US
Practice Address - Phone:775-982-5000
Practice Address - Fax:775-982-2900
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1998363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV14272340OtherCAQH
NVPA1998OtherPA NEVADA