Healthcare Provider Details

I. General information

NPI: 1952958498
Provider Name (Legal Business Name): MEREDITH OLMSTEAD AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 09/29/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 DAVE WARD DR #101
LITTLE ROCK AR
72205
US

IV. Provider business mailing address

PO BOX 251420
LITTLE ROCK AR
72225-1420
US

V. Phone/Fax

Practice location:
  • Phone: 501-932-7600
  • Fax:
Mailing address:
  • Phone: 501-686-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY2302
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number201366
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: