Individual
KIERSTYN L. BLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2275 DEMING WAY STE 240, MIDDLETON, WI 53562-5527
(608) 821-4020
(608) 821-4040
Mailing address
1808 W BELTLINE HWY, MADISON, WI 53713-2334
(608) 250-1497
(608) 250-1384
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1815-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083679757
—
WI
Enumeration date
04/18/2006
Last updated
11/03/2020
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