Provider Demographics
NPI:1487784872
Name:MEEKS, KRISTA L (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:L
Last Name:MEEKS
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 N WIMBERLY DR FL 2
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4056
Mailing Address - Country:US
Mailing Address - Phone:479-587-3185
Mailing Address - Fax:479-587-3185
Practice Address - Street 1:3317 N WIMBERLY DR FL 2
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4056
Practice Address - Country:US
Practice Address - Phone:479-587-3185
Practice Address - Fax:479-587-3185
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003025243225X00000X
AROTR3648225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO477452403Medicaid