Healthcare Provider Details

I. General information

NPI: 1477479160
Provider Name (Legal Business Name): MS. MEGAN ELIZABETH HOLMES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W POPLAR ST
ROGERS AR
72756-4242
US

IV. Provider business mailing address

1000 W POPLAR ST
ROGERS AR
72756-4242
US

V. Phone/Fax

Practice location:
  • Phone: 479-631-7678
  • Fax: 479-332-3827
Mailing address:
  • Phone: 479-631-7678
  • Fax: 479-332-3827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOTR4240
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: