Provider Demographics
NPI:1275417370
Name:MINARD, CAITLYN ELIZABETH
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:ELIZABETH
Last Name:MINARD
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 1:11765 CINDER RD
Mailing Address - Street 2:
Mailing Address - City:BEULAH
Mailing Address - State:MI
Mailing Address - Zip Code:49617-9741
Mailing Address - Country:US
Mailing Address - Phone:231-383-2974
Mailing Address - Fax:
Practice Address - Street 1:11765 CINDER RD
Practice Address - Street 2:
Practice Address - City:BEULAH
Practice Address - State:MI
Practice Address - Zip Code:49617-9741
Practice Address - Country:US
Practice Address - Phone:231-383-2974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI14462CM374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula