| Kristina Lauren Kishimoto, | |
|
1120 15th St, Augusta, GA 30912-0004 | |
| (706) 721-2482 | |
| Not Available |
| Full Name | Kristina Lauren Kishimoto |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 1120 15th St, Augusta, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063864882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | SLP008932 (Georgia) | Primary |
| Provider Name | Au Medical Center, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1437135902 PECOS PAC ID: 7618866229 Enrollment ID: O20040312000081 |
| Provider Name | Wellstar Medical Group, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
| Mailing Address | Practice Location Address |
|---|---|
| Kristina Lauren Kishimoto, 2012 Kew Ct, Grovetown, GA 30813-5891 Ph: () - | Kristina Lauren Kishimoto, 1120 15th St, Augusta, GA 30912-0004 Ph: (706) 721-2482 |
Haleigh Swierski Mahaffey, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3104 Skinner Mill Rd, Augusta, GA 30909 Phone: 706-522-4222 | |
Flynt Stebbins Connor, M.S., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1350 Walton Way, Augusta, GA 30901 Phone: 706-774-2166 Fax: 706-774-3761 | |
Laura Enz, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1350 Walton Way, Augusta, GA 30901 Phone: 706-774-2166 Fax: 706-774-3761 | |
Katie Teresa Day, M.ED CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3104 Skinner Mill Rd, Augusta, GA 30909 Phone: 706-522-4222 | |
Amanda Hatfield Hutter, CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1120 15th St Ste Bi1056, Augusta, GA 30912 Phone: 706-721-3813 Fax: 706-721-1459 | |
Jill Painter, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2315 Central Ave Ste C, Augusta, GA 30904 Phone: 706-364-6172 | |
Rebecca Russell Darr, M.S.P. Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1426 1/2 Anthony Rd, Augusta, GA 30904 Phone: 864-590-5652 |