Provider Demographics
NPI:1790931301
Name:NORD, KRISTI MAHAFFEY (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:MAHAFFEY
Last Name:NORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:KRISTI
Other - Middle Name:ELIZABETH
Other - Last Name:MAHAFFEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 E CHESTNUT ST UNIT 510
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-5710
Practice Address - Country:US
Practice Address - Phone:502-588-4800
Practice Address - Fax:502-588-4801
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01071049A2084N0400X
TXBP200302772084N0400X
KY438602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000689395OtherANTHEM - NNS
KYP00889607OtherMEDICARE RAILROAD KENTUCKY - NNS
KY7100144920Medicaid
IN201010010Medicaid
KY50031018OtherPASSPORT & PP ADVTG - NNS
KY6214811OtherCIGNA - NNS
KY000057058SOtherHUMANA - NNS
KY121031OtherSIHO - NNS
KYK046540Medicare PIN
KYP400032164Medicare PIN