| Kierstyn Johnson-wigfall, | |
|
13900 Hull Street Rd, Midlothian, VA 23112-2004 | |
| (804) 639-8788 | |
| Not Available |
| Full Name | Kierstyn Johnson-wigfall |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 13900 Hull Street Rd, Midlothian, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932569712 | NPI | - | NPPES |
| 1932569712 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 2202006559 (Virginia) | Primary |
| Provider Name | Functional Pathways Preferred Of Tennessee Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1841561446 PECOS PAC ID: 2860649654 Enrollment ID: O20120830000086 |
| Mailing Address | Practice Location Address |
|---|---|
| Kierstyn Johnson-wigfall, 12001 Iron Bridge Rd, Chester, VA 23831-1460 Ph: () - | Kierstyn Johnson-wigfall, 13900 Hull Street Rd, Midlothian, VA 23112-2004 Ph: (804) 639-8788 |
Miss Kathryn Easley, M.S., CF-SLP Speech-Language Pathologist Medicare: Accepting Medicare Assignments Practice Location: 1 Park West Cir, Suite 108, Midlothian, VA 23114 Phone: 800-969-9265 Fax: 804-482-2647 | |
Hayley Wenner, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 13900 Hull Street Rd, Midlothian, VA 23112 Phone: 804-639-8900 | |
Sonya Willard, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 13900 Hull Street Rd, Midlothian, VA 23112 Phone: 804-639-8788 | |
Karen Sue Ford, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 13714 Nashua Ter, Midlothian, VA 23112 Phone: 804-683-8470 | |
Molly Shearer, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 13900 Hull Street Rd, Midlothian, VA 23112 Phone: 804-639-8788 | |
Jennie Watson, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 13900 Hull Street Rd, Midlothian, VA 23112 Phone: 804-639-8788 | |
Caroline E Short, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 13900 Hull Street Rd, Midlothian, VA 23112 Phone: 804-639-8900 |