Provider Demographics
NPI:1801043427
Name:PIERCE, KRISTIN M (OD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:M
Last Name:PIERCE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 W 119TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1108
Mailing Address - Country:US
Mailing Address - Phone:913-345-2020
Mailing Address - Fax:913-345-2662
Practice Address - Street 1:7500 W 119TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1108
Practice Address - Country:US
Practice Address - Phone:913-345-2020
Practice Address - Fax:913-345-2662
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1821152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist