Most Relevant Information
Provider Data
| NPI Number: | 1003184714 |
| Provider Name: | KIERSTEN SPERRY |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA195464 |
Most Important Dates
| Enumeration Date: | 12/08/2011 |
| Last Updated: | 05/18/2020 |
Provider Practice Location
2282 NW TROOST ST STE 103
ROSEBURG
OR
974716072
Practice Location Phone/Fax
| Phone: | 5416724798 |
| Fax: |
Provider Mailing Location
393 N 100 E
PROVIDENCE
UT
843329829
Provider Mailing Phone/Fax
| Phone: | 8018332437 |
| Fax: |