Provider Demographics
NPI:1477228807
Name:HINSON, KRISTA FULBRIGHT (OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:FULBRIGHT
Last Name:HINSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:RENEE
Other - Last Name:FULBRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1768 RAD DR
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-9378
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 RIVER BEND DR
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-9376
Practice Address - Country:US
Practice Address - Phone:828-212-5121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10615225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist