Provider Demographics
NPI:1609964998
Name:PINNOW, KRISTIN JENNIFER (PH D)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:JENNIFER
Last Name:PINNOW
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:JENNIFER
Other - Last Name:SEWALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PH D
Mailing Address - Street 1:2062 PRO POINTE LN
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8021
Mailing Address - Country:US
Mailing Address - Phone:540-434-2255
Mailing Address - Fax:540-434-8778
Practice Address - Street 1:2062 PRO POINTE LN
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8021
Practice Address - Country:US
Practice Address - Phone:540-434-2255
Practice Address - Fax:540-434-8778
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001256231H00000X
VA2101001462237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA138421OtherANTHEM INS
VAC08773OtherMEDICARE PTAN
VAC08773OtherMEDICARE PTAN
Q25098Medicare UPIN