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NPI Code Detail

MEDICARE: KATIE KIERNAN

MEDICARE: KATIE KIERNAN
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1073466579
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE KIERNAN
Provider Business Mailing Address
First Line : 301 SHIRETON CT
Second Line :
City : SWANSEA
State : IL
Zip : 62226-8908
Country : US
Telephone Number : 618-741-3802
Fax Number :
Provider Business Practice Location Address
First Line : 726 4TH ST
Second Line :
City : MARYSVILLE
State : CA
Zip : 95901-5656
Country : US
Telephone Number : 530-749-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2026
Last Update Date : 02/16/2026

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Directions to “ KATIE KIERNAN ” Practice Location

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