Provider Demographics
NPI:1609676253
Name:CHALKLEY, CAITLIN MARIE (RN)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MARIE
Last Name:CHALKLEY
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 SW PICKFORD ST APT A
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-1684
Mailing Address - Country:US
Mailing Address - Phone:386-214-3792
Mailing Address - Fax:
Practice Address - Street 1:2555 SW PICKFORD ST APT A
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-1684
Practice Address - Country:US
Practice Address - Phone:386-214-3792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10030319163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine