Provider Demographics
NPI:1417269911
Name:MCCAIN, CATHERINE NICOLE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:NICOLE
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:NICOLE
Other - Last Name:LANDRETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5800 W 10TH ST
Mailing Address - Street 2:STE 205
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-1752
Mailing Address - Country:US
Mailing Address - Phone:501-661-0077
Mailing Address - Fax:501-664-2749
Practice Address - Street 1:5800 W 10TH ST
Practice Address - Street 2:STE 205
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1752
Practice Address - Country:US
Practice Address - Phone:501-661-0077
Practice Address - Fax:501-664-2749
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist