Provider Demographics
NPI:1427390459
Name:DERBY, KIERSTEN SMITH (MD, MPH)
Entity Type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:SMITH
Last Name:DERBY
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CENTREPARK DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1262
Mailing Address - Country:US
Mailing Address - Phone:828-254-4337
Mailing Address - Fax:828-251-9240
Practice Address - Street 1:500 CENTREPARK DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-1262
Practice Address - Country:US
Practice Address - Phone:828-254-4337
Practice Address - Fax:828-251-9240
Is Sole Proprietor?:No
Enumeration Date:2013-03-16
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1427390459208000000X
NC2021-02570208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1427390459Medicaid