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General NPI Number Information
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NPI Number | 1689220394
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Entity Type | Individual
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Provider Name | CORIN ANN KIERSON
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Gender | Female
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Dates
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Enumeration Date | 08/18/2019
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Last Update Date | 08/18/2019
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Provider Practice Location Address
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Address Line | 9072 109TH TER
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City | LARGO
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State | FL
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Zip | 33777-1109
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Country | US
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Telephone | 727-422-8342
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Fax |
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Provider Business Mailing Address
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Address Line | 405 BOUGH AVE
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City | CLEARWATER
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State | FL
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Zip | 33760-1505
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Country | US
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Telephone | 727-222-2156
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Fax | 813-844-4057
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | CNA289805
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License Number State | FL
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