Provider Demographics
NPI:1881220531
Name:MERONEY, KRISSA ANN
Entity Type:Individual
Prefix:
First Name:KRISSA
Middle Name:ANN
Last Name:MERONEY
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 1:1905 16TH ST NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2151
Mailing Address - Country:US
Mailing Address - Phone:828-334-5020
Mailing Address - Fax:
Practice Address - Street 1:1899 TATE BLVD SE UNIT 2106
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4200
Practice Address - Country:US
Practice Address - Phone:828-358-0976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer