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NPI Code Detail

MEDICARE: KRISTINA RUPP MS, OTRL

MEDICARE: KRISTINA RUPP MS, OTRL
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
1225X00000XOccupational TherapistOTR1823AR
2225XP0200XPediatric Occupational TherapistOTR1823AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15X307OTHERARBCBS

General Provider Information

NPI Number : 1710035092
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA RUPP MS, OTRL
Provider Business Mailing Address
First Line : 10618 BRECKENRIDGE DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-1802
Country : US
Telephone Number : 501-217-8600
Fax Number : 501-217-8636
Provider Business Practice Location Address
First Line : 10618 BRECKENRIDGE DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-1802
Country : US
Telephone Number : 501-217-8600
Fax Number : 501-217-8636
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2007
Last Update Date : 09/11/2025

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Directions to “ KRISTINA RUPP MS, OTRL” Practice Location

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