Individual
KIRSTEN ANNE HERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2564 NE COURTNEY DR, BEND, OR 97701-7638
(541) 678-5277
Mailing address
2724 NW RAINBOW RIDGE DR, BEND, OR 97701-8722
(541) 678-5277
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00936
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500622201
—
OR
01
—
PA00936
LICENSE
OR
Enumeration date
02/01/2006
Last updated
03/07/2023
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