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Individual

KIERSTIN LEALIIEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6410 S KINGS RANCH RD STE 1, GOLD CANYON, AZ 85118-7352
(480) 761-2500
(480) 288-2879
Mailing address
219 N 2940 E, ST GEORGE, UT 84790-7096
(602) 489-1313

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10838
AZ
363AM0700X
Medical Physician Assistant
11959125-1206
UT
363AM0700X
Medical Physician Assistant
PA2437
NV

Other

Enumeration date
06/24/2020
Last updated
02/17/2025
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