Provider Demographics
NPI:1245963693
Name:CAULDRON, KERRI RAVEN (PHARMD)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:RAVEN
Last Name:CAULDRON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 BOWEN ST UNIT 8
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2200
Mailing Address - Country:US
Mailing Address - Phone:541-977-3393
Mailing Address - Fax:
Practice Address - Street 1:117 CHAPMAN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-5400
Practice Address - Country:US
Practice Address - Phone:401-444-9909
Practice Address - Fax:401-444-4905
Is Sole Proprietor?:No
Enumeration Date:2022-07-04
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0019151183500000X
RIRPH066141835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist