Provider Demographics
NPI:1477647394
Name:LOWERY, KRISTI MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:MICHELLE
Last Name:LOWERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3691 CHAPEL DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-8003
Mailing Address - Country:US
Mailing Address - Phone:870-863-3011
Mailing Address - Fax:870-862-2100
Practice Address - Street 1:214 HOPE LANDING
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-0000
Practice Address - Country:US
Practice Address - Phone:870-862-0500
Practice Address - Fax:870-862-2100
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR969225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist