Provider Demographics
NPI:1770698656
Name:MEEKER, KAREN ANN (RPT)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANN
Last Name:MEEKER
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 60 BOX 13
Mailing Address - Street 2:
Mailing Address - City:BONNERS FERRY
Mailing Address - State:ID
Mailing Address - Zip Code:83805-9503
Mailing Address - Country:US
Mailing Address - Phone:208-267-2803
Mailing Address - Fax:208-267-3048
Practice Address - Street 1:HC 60 BOX 13
Practice Address - Street 2:
Practice Address - City:BONNERS FERRY
Practice Address - State:ID
Practice Address - Zip Code:83805-9503
Practice Address - Country:US
Practice Address - Phone:208-267-2803
Practice Address - Fax:208-267-3048
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-133225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDQ02172Medicare UPIN
ID1654996Medicare ID - Type UnspecifiedPHYSICAL THERAPY