Provider Demographics
NPI:1366198491
Name:MONACO, CAITLIN DRENNAN (PA-C)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:DRENNAN
Last Name:MONACO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:ELIZABETH
Other - Last Name:DRENNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:132 EDMER LN
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-9278
Mailing Address - Country:US
Mailing Address - Phone:910-286-8044
Mailing Address - Fax:
Practice Address - Street 1:132 EDMER LN
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-9278
Practice Address - Country:US
Practice Address - Phone:910-286-8044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-28
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-12059363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant