Individual
KIRSTEN MORTENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3636 N STOCKTON HILL RD, KINGMAN, AZ 86409-0514
(928) 757-4398
(928) 757-7224
Mailing address
3636 N STOCKTON HILL RD, KINGMAN, AZ 86409-0514
(928) 757-3611
(928) 757-7224
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2779
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066987
—
AZ
Enumeration date
09/09/2005
Last updated
07/08/2007
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