Provider Demographics
NPI:1346457041
Name:CRAFT, MENDY KAY (PTA)
Entity type:Individual
Prefix:MRS
First Name:MENDY
Middle Name:KAY
Last Name:CRAFT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2236 HARRISON ST AMEDISYS HOME HEALTH
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501
Mailing Address - Country:US
Mailing Address - Phone:870-793-1483
Mailing Address - Fax:870-698-6519
Practice Address - Street 1:2236 HARRISON ST AMEDISYS HOME HEALTH
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501
Practice Address - Country:US
Practice Address - Phone:870-793-1483
Practice Address - Fax:870-698-6519
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1747225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR139191721Medicaid