Provider Demographics
NPI:1497897680
Name:KISLER, NANCY C (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:C
Last Name:KISLER
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-2046
Mailing Address - Country:US
Mailing Address - Phone:270-676-7010
Mailing Address - Fax:
Practice Address - Street 1:712 W 15TH ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-2046
Practice Address - Country:US
Practice Address - Phone:270-889-6047
Practice Address - Fax:270-889-6050
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY226231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100210030Medicaid
KYK048366Medicare PIN
KYK048365Medicare PIN
KYK048361Medicare PIN
KYK048362Medicare PIN
KYK048360Medicare PIN
KY7100210030Medicaid
KYK048363Medicare PIN