Provider Demographics
NPI:1639307036
Name:JOLKOWSKI, KRISTIN L (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:L
Last Name:JOLKOWSKI
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:L
Other - Last Name:SIMMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 S 48TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1276
Mailing Address - Country:US
Mailing Address - Phone:402-488-5600
Mailing Address - Fax:402-488-7649
Practice Address - Street 1:1500 S 48TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1276
Practice Address - Country:US
Practice Address - Phone:402-488-5600
Practice Address - Fax:402-488-7649
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE276231H00000X
NE099237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE276OtherNEBRASKA STATE AUDIOLOGY LICENSE