Kortni Reann Martindale, SLP
Individual provider Active NPI Speech-Language Pathologist · Sullivan, IN
NPI 1487828455 · NPPES record last updated Apr 21, 2008
Key facts
- NPI
- 1487828455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 22004417A (IN)
- Practice address
- 368 W Indiana Ave
Sullivan, IN 47882-1117 - Phone
- (812) 564-1229
- Fax
- (812) 268-3947
- NPI assigned
- Apr 21, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22004417A | IN | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 22004417A | IN | Yes |
Addresses
Primary practice location
368 W Indiana Ave
Sullivan, IN 47882-1117
Mailing address
368 W Indiana Ave
Sullivan, IN 47882-1117
Phone (812) 564-1229
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200866400 A | Other | IN | LEGACY PROVIDER IDENTIFIER |
Other providers in Sullivan, IN
- Holly Laue
- Joseph B Lee
- LHCG Xxviii, LLC
- Jeanna Rennee Lisman
- Magnolia Health Systems 49, LLC
- Mary Ann Chavez DO
- Mary Ann Chavez DO PC
- Amanda Matthews-Hargrave
- Medlife Inc
- Eric Morse
All providers in Sullivan, IN · Speech-Language Pathologist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.