Provider Demographics
NPI:1053881615
Name:NESTER, KRISTI JOY (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:JOY
Last Name:NESTER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13609 MITCHELLS WAY
Mailing Address - Street 2:
Mailing Address - City:WEST FRIENDSHIP
Mailing Address - State:MD
Mailing Address - Zip Code:21794
Mailing Address - Country:US
Mailing Address - Phone:410-461-5899
Mailing Address - Fax:
Practice Address - Street 1:1460 CARRS MILL ROAD
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:MD
Practice Address - Zip Code:21738
Practice Address - Country:US
Practice Address - Phone:410-313-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04290235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist