Provider Demographics
NPI:1790216299
Name:MASKREY, CAITI NICOLE (DO)
Entity Type:Individual
Prefix:DR
First Name:CAITI
Middle Name:NICOLE
Last Name:MASKREY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM ST
Mailing Address - Street 2:MAIL SLOT 589
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-526-8148
Mailing Address - Fax:501-526-8198
Practice Address - Street 1:4301 W MARKHAM ST
Practice Address - Street 2:MAIL SLOT 589
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-526-8148
Practice Address - Fax:501-526-8198
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-25
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34.0149322084F0202X
ARE-129332084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry