Individual
KIERSTEN SIMONE LA ROCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
850 HARRISON AVENUE, YACC 5, BOSTON, MA 02118-4001
(617) 414-2000
(617) 414-5798
Mailing address
801 ALBANY STREET, FL G, BOSTON, MA 02119-3791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA8047
MA
Other
Enumeration date
06/02/2020
Last updated
02/04/2022
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