Healthcare Provider Details
I. General information
NPI: 1275791840
Provider Name (Legal Business Name): KIERSTIN MARIA LUND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/29/2008
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US
IV. Provider business mailing address
1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US
V. Phone/Fax
- Phone: 504-842-3755
- Fax:
- Phone: 504-842-4000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | P49873 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | E-16467 |
| License Number State | AR |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP3000X |
| Taxonomy | Pediatric Anesthesiology Physician |
| License Number | E-16467 |
| License Number State | AR |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP3000X |
| Taxonomy | Pediatric Anesthesiology Physician |
| License Number | MD.199902 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: