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NPI Code Detail

MEDICARE: KIERAN STEMM

MEDICARE: KIERAN STEMM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramMN

General Provider Information

NPI Number : 1184580805
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIERAN STEMM
Provider Business Mailing Address
First Line : 1031 3RD ST SE
Second Line :
City : FOREST LAKE
State : MN
Zip : 55025-1821
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1900 SILVER LAKE RD NW STE 110
Second Line :
City : NEW BRIGHTON
State : MN
Zip : 55112-1789
Country : US
Telephone Number : 651-628-9566
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2025
Last Update Date : 12/26/2025

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Directions to “ KIERAN STEMM ” Practice Location

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