Provider Demographics
NPI:1346529930
Name:CREEL, JOYCE ANN (OTA)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:CREEL
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 N TIMBER LANE DR
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-9202
Mailing Address - Country:US
Mailing Address - Phone:316-712-3686
Mailing Address - Fax:
Practice Address - Street 1:2320 N TIMBER LANE DR
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-9202
Practice Address - Country:US
Practice Address - Phone:316-712-3686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-000-44224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant