Individual
TRISTYN AMY PIERCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10202 W 13TH ST N, WICHITA, KS 67212-4377
(316) 729-9100
(316) 729-9185
Mailing address
10202 W 13TH ST N, WICHITA, KS 67212-4377
(316) 729-9100
(316) 729-9185
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-32917
KS
207R00000X
Internal Medicine Physician
MD00046116
WA
208000000X
Pediatrics Physician
04-32917
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039581
L&I
WA
05
—
8465775
—
WA
01
—
8851PI
BLUE SHIELD
WA
01
—
US7603833
AETNA
WA
Enumeration date
07/25/2006
Last updated
06/09/2014
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