Provider Demographics
NPI:1225790330
Name:CAISE, CHARELLE LENITA (APRN, AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:CHARELLE
Middle Name:LENITA
Last Name:CAISE
Suffix:
Gender:F
Credentials:APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 COLLINS INDUSTRIAL WAY APT 2313
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-6759
Mailing Address - Country:US
Mailing Address - Phone:859-312-9587
Mailing Address - Fax:
Practice Address - Street 1:5910 SUWANEE DAM RD # 200
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-5648
Practice Address - Country:US
Practice Address - Phone:678-714-3053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN306972208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation