KIRSTEN MICAELA KETCHERSID NPI 1295475788

NPI Information

NPI: 1295475788
Provider Name: KIRSTEN MICAELA KETCHERSID
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
12895 JOSEY LN STE 114
DALLAS, TX
ZIP 75234
Phone: (972) 532-9967
Get Directions

Kirsten Micaela Ketchersid is a pediatrics nurse practitioner in Dallas, TX. Kirsten Micaela Ketchersid NPI is 1295475788. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

12895 JOSEY LN STE 114
DALLAS, TX
ZIP 75234-300
Phone: (972) 532-9967
Fax: (972) 495-2287

The enumeration date for this NPI number is 3/31/2022 and was last updated on 3/31/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	1019995	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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