Basic Information
| Provider Information | |||||||||
| NPI: | 1700389491 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOSEPH | ||||||||
| FirstName: | KIERSTEN | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 MCCONNELL DR | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432143463 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145336297 | ||||||||
| FaxNumber: | 6145336226 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 MCCONNELL DR | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432143463 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145336297 | ||||||||
| FaxNumber: | 6145336226 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2018 | ||||||||
| LastUpdateDate: | 08/30/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RH0002X | 34.015884 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine |
No ID Information.