Provider Demographics
NPI:1790103547
Name:KIRKLAND, SIERA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:SIERA
Middle Name:MARIE
Last Name:KIRKLAND
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:704-384-3145
Mailing Address - Fax:704-384-3145
Practice Address - Street 1:1401 MATTHEWS TOWNSHIP PKWY STE 320
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5403
Practice Address - Country:US
Practice Address - Phone:704-384-1261
Practice Address - Fax:704-384-3145
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-30
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
NC2018-007712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program