Provider Demographics
NPI:1447096607
Name:PARKER, CAITLIN ELLICE (PT, DPT)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ELLICE
Last Name:PARKER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 DOUBLE R BLVD UNIT 1128
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-9034
Mailing Address - Country:US
Mailing Address - Phone:775-846-8382
Mailing Address - Fax:
Practice Address - Street 1:2350 WINGFIELD HILLS RD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-7220
Practice Address - Country:US
Practice Address - Phone:775-335-8275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-06
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5167225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist