Provider Demographics
NPI:1578349080
Name:YAHLE, KIERSTAN NICOLE
Entity Type:Individual
Prefix:
First Name:KIERSTAN
Middle Name:NICOLE
Last Name:YAHLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WETHERBURN DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-2519
Mailing Address - Country:US
Mailing Address - Phone:937-823-4351
Mailing Address - Fax:
Practice Address - Street 1:100 WETHERBURN DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-2519
Practice Address - Country:US
Practice Address - Phone:937-823-4351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program