MEDICARE: KIERSTEN ANDERSON

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
1	237600000X	Audiologist-Hearing Aid Fitter	AT005920	PA

General Provider Information

NPI Number	:	1538355979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIERSTEN ANDERSON

Provider Business Mailing Address
First Line	:	824 MAIN ST
Second Line	:	SUITE 201
City	:	PHOENIXVILLE
State	:	PA
Zip	:	19460-4478
Country	:	US
Telephone Number	:	610-415-1100
Fax Number	:	610-415-1101

Provider Business Practice Location Address
First Line	:	7691 5 MILE RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-4348
Country	:	US
Telephone Number	:	513-421-5558
Fax Number	:	513-632-5804

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	11/28/2018

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Directions to “ KIERSTEN ANDERSON ” Practice Location

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