MEDICARE: KRISTY MEEKS APRN

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
1	163W00000X	Registered Nurse	R00 67403	OK
2	163W00000X	Registered Nurse	833049	TX
3	363LF0000X	Family Nurse Practitioner	67403	OK

General Provider Information

NPI Number	:	1144637026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTY MEEKS APRN

Provider Business Mailing Address
First Line	:	321 E. MAIN ST
Second Line	:
City	:	DAVIS
State	:	OK
Zip	:	73030-1905
Country	:	US
Telephone Number	:	580-247-9718
Fax Number	:	866-682-7623

Provider Business Practice Location Address
First Line	:	321 E MAIN ST
Second Line	:
City	:	DAVIS
State	:	OK
Zip	:	73030-1905
Country	:	US
Telephone Number	:	580-247-9718
Fax Number	:	866-682-7623

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2014
Last Update Date	:	05/15/2019

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Directions to “ KRISTY MEEKS APRN” Practice Location

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