Healthcare Provider Details

I. General information

NPI: 1821936782
Provider Name (Legal Business Name): ABBY KISH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 SURRY LINE RD
PINNACLE NC
27043-9027
US

IV. Provider business mailing address

100 COURTHOUSE CIR
DANBURY NC
27016-7600
US

V. Phone/Fax

Practice location:
  • Phone: 336-368-2990
  • Fax:
Mailing address:
  • Phone: 336-536-9010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30001013
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: