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NPI Code Detail

MEDICARE: KRISTEN NICOLE BURNETT M.A., CCC-SLP

MEDICARE: KRISTEN NICOLE BURNETT M.A., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist248564KY

General Provider Information

NPI Number : 1891342531
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN NICOLE BURNETT M.A., CCC-SLP
Provider Business Mailing Address
First Line : 82 JOE E DELL RD
Second Line :
City : PINEVILLE
State : KY
Zip : 40977-8202
Country : US
Telephone Number : 606-269-2144
Fax Number :
Provider Business Practice Location Address
First Line : 8706 S US HIGHWAY 25
Second Line :
City : CORBIN
State : KY
Zip : 40701-4974
Country : US
Telephone Number : 606-677-1166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2019
Last Update Date : 08/19/2019

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