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NPI Code Detail

MEDICARE: DR. KAITLIN BROOKE MCCANN PHARMD

MEDICARE: DR. KAITLIN BROOKE MCCANN PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPD15442AR

General Provider Information

NPI Number : 1316547896
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAITLIN BROOKE MCCANN PHARMD
Provider Business Mailing Address
First Line : 75 RIVERFRONT DR APT 448
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72114-5779
Country : US
Telephone Number : 501-259-2637
Fax Number :
Provider Business Practice Location Address
First Line : 8824 GEYER SPRINGS RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72209-4765
Country : US
Telephone Number : 501-565-7584
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2020
Last Update Date : 10/26/2020

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