Provider Demographics
NPI:1467917344
Name:ANDERSON, CAITLIN SCHNEIDER
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:SCHNEIDER
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19503 WAVERUNNER LN APT 302
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-6471
Mailing Address - Country:US
Mailing Address - Phone:817-938-1198
Mailing Address - Fax:
Practice Address - Street 1:16455 STATESVILLE RD STE 300
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7139
Practice Address - Country:US
Practice Address - Phone:704-801-3719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP18592225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist