Provider Demographics
NPI:1760291322
Name:MCPHERSON, CAITLIN (RD, LD, CLC)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:RD, LD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 CHAPMON LN
Mailing Address - Street 2:
Mailing Address - City:STUTTGART
Mailing Address - State:AR
Mailing Address - Zip Code:72160-2591
Mailing Address - Country:US
Mailing Address - Phone:870-615-2279
Mailing Address - Fax:
Practice Address - Street 1:1602 N BUERKLE ST
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160-2516
Practice Address - Country:US
Practice Address - Phone:870-615-2279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1790133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered