Individual
DR. NINA MILLER KIEKHAEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
(573) 634-7423
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 635-5264
(573) 634-7423
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
117863
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080176048
RAILROAD MEDICARE
MO
05
—
204707103
—
MO
01
—
CC7852
RR GROUP
MO
Enumeration date
12/22/2005
Last updated
06/28/2023
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