Provider Demographics
NPI:1124366943
Name:HANKS, MERIDETH KAREN (APN)
Entity type:Individual
Prefix:
First Name:MERIDETH
Middle Name:KAREN
Last Name:HANKS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 RIFE MEDICAL LN STE 200
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1456
Mailing Address - Country:US
Mailing Address - Phone:479-338-3080
Mailing Address - Fax:479-338-3089
Practice Address - Street 1:2708 RIFE MEDICAL LN STE 200
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1456
Practice Address - Country:US
Practice Address - Phone:479-338-3080
Practice Address - Fax:479-338-3089
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003821363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner