Provider Demographics
NPI:1447539994
Name:JARVIS, CAITLIN ANNE (PA)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ANNE
Last Name:JARVIS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:ANNE
Other - Last Name:POIRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:NATIONAL INSTITUTES OF HEALTH
Mailing Address - Street 2:10 CENTER DRIVE BUILDING 10 OFFICE 6D44
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:240-549-4251
Mailing Address - Fax:
Practice Address - Street 1:NATIONAL INSTITUTES OF HEALTH
Practice Address - Street 2:10 CENTER DRIVE BUILDING 10 OFFICE 6D44
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:240-549-4251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015128-1363A00000X
MDC0008500363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant