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Individual

KRISTEN D KIERSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
3231 S NATIONAL AVE, STE 115, SPRINGFIELD, MO 65807-7304
(417) 888-5666
(417) 890-4174
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20010014016
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1962815854
MO
01
431560263
TRICARE
MO
01
P01094291
RR MCR
MO
Enumeration date
07/20/2010
Last updated
12/12/2012
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