=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346134277
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIN LAURETTE KOKINDA AU.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/05/2025
-----------------------------------------------------
Last Update Date | 06/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 MOYE BLVD
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27834-2885
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-830-2149
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 305 CHEBISTAL DR
-----------------------------------------------------
City | GRIFTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28530-7053
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-934-0562
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 30004024
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------