Abbott, Kristi Deshannon
Abbott, Kristi Deshannon is an individual health care provider with primary practice located at 136 Gateway Blvd Ste A , Mooresville NC 28117-5608. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Abbott, Kristi Deshannon can be contacted via phone (704) 799-2878.Contact Information
Primary practice address
136 Gateway Blvd Ste A
Mooresville NC 28117-5608
Phone: (704) 799-2878
Fax: (704) 799-1627
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2009-00630 | North Carolina |
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 2009-00630 | North Carolina |
Profile Details
| NPI number | 1457489973 |
|---|---|
| LBN Legal business name | Abbott, Kristi Deshannon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 28th, 2007 |
| Last updated | Aug 31st, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457489973 | NPPES |
| North Carolina | MEDICAID | 1457489973 | |
| North Carolina | MEDICAID | NC1018 | |
| North Carolina | MEDICAID | 5912736 |
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