Provider Demographics
NPI:1578207684
Name:DUTRO, CAITLIN MARIE (CNP)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MARIE
Last Name:DUTRO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 OLENTANGY RIVER RD STE 1080
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3984
Mailing Address - Country:US
Mailing Address - Phone:567-230-2860
Mailing Address - Fax:
Practice Address - Street 1:3555 OLENTANGY RIVER RD STE 1080
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3984
Practice Address - Country:US
Practice Address - Phone:614-268-8164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.436405163WC0200X
OHAPRN.CNP.0031758363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine