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NPI 1568371920

NPI 1568371920 : KAITLIN FOURNIE HIS : PEACHTREE CITY, GA

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General NPI Number Information
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    NPI Number           |    1568371920
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    Entity Type          |    Individual 
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    Provider Name        |    KAITLIN FOURNIE HIS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/02/2026
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    Last Update Date     |    09/02/2026
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Provider Practice Location Address
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    Address Line         |    3035 STATE ST 
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    City                 |    PEACHTREE CITY
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    State                |    GA
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    Zip                  |    30269-1598
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    Country              |    US
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    Telephone            |    770-213-6366
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    Fax                  |    770-430-2948
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Provider Business Mailing Address
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    Address Line         |    3035 STATE ST 
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    City                 |    PEACHTREE CITY
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    State                |    GA
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    Zip                  |    30269-1598
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    Country              |    US
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    Telephone            |    770-213-6366
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    Fax                  |    770-430-2948
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    237700000X
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    Taxonomy Name        |    Hearing Instrument Specialist
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    License Number       |    HADS001206
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    License Number State |    GA
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