Provider Demographics
NPI:1427061837
Name:CONNER, KRISTI M (AUD)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:M
Last Name:CONNER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2475 NORTHPARK DR STE 10
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-2215
Mailing Address - Country:US
Mailing Address - Phone:812-372-1886
Mailing Address - Fax:812-372-8156
Practice Address - Street 1:2475 NORTHPARK DR STE 10
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-2215
Practice Address - Country:US
Practice Address - Phone:812-372-1886
Practice Address - Fax:812-372-8156
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002396A231HA2400X, 231HA2500X, 237600000X, 231H00000X, 231HA2500X, 237600000X
MI1601000266231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200857830Medicaid