Krystina Anne Carrino-Morris, LMT
Individual provider Active NPI Specialist · Louisville, GA
NPI 1831470152 · NPPES record last updated Aug 31, 2011
Key facts
- NPI
- 1831470152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MT007683 (GA)
- Practice address
- 117 W Broad St
Louisville, GA 30434-1627 - Phone
- (478) 625-8855
- NPI assigned
- Aug 31, 2011
- 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 |
|---|---|---|---|
| MT007683 | GA | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MT007683 | GA | Yes |
Addresses
Primary practice location
117 W Broad St
Louisville, GA 30434-1627
Mailing address
117 W Broad St
Louisville, GA 30434-1627
Phone (478) 625-8855
Other providers in Louisville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2011. 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.