Provider Demographics
NPI:1871598961
Name:CAULDWELL, GAYLA SUE (ARNP-C)
Entity type:Individual
Prefix:
First Name:GAYLA
Middle Name:SUE
Last Name:CAULDWELL
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3251 OLD LEE HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-1504
Mailing Address - Country:US
Mailing Address - Phone:778-684-8278
Mailing Address - Fax:
Practice Address - Street 1:1604 SPRING HILL RD STE 450
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-7509
Practice Address - Country:US
Practice Address - Phone:703-270-4300
Practice Address - Fax:703-270-4350
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001171562163WH1000X
VA0024164471363LA2200X, 363LA2200X
OHNP09422363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice