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Individual

KRISTI DESHANNON ABBOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2009-00630
NC
2080A0000X
Pediatric Adolescent Medicine Physician
2009-00630
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1457489973
NC
05
5912736
NC
05
NC1018
SC
Enumeration date
02/28/2007
Last updated
08/31/2015
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