Healthcare Provider Details

I. General information

NPI: 1487784872
Provider Name (Legal Business Name): KRISTA L MEEKS OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 04/18/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3317 N WIMBERLY DR FL 2
FAYETTEVILLE AR
72703-4056
US

IV. Provider business mailing address

3317 N WIMBERLY DR FL 2
FAYETTEVILLE AR
72703-4056
US

V. Phone/Fax

Practice location:
  • Phone: 479-587-3185
  • Fax: 479-587-3185
Mailing address:
  • Phone: 479-587-3185
  • Fax: 479-587-3185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2003025243
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOTR3648
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: