Provider Demographics
NPI:1619181898
Name:KIEHNA, ERIN NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:KIEHNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-3070
Mailing Address - Fax:704-316-3071
Practice Address - Street 1:330 BILLINGSLEY RD STE 202
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-5020
Practice Address - Country:US
Practice Address - Phone:704-316-3070
Practice Address - Fax:704-316-3071
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA126001207T00000X
VA0116018505390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program