Provider Demographics
NPI:1831289461
Name:STOESSER, KIRSTEN L (MD)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:L
Last Name:STOESSER
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 1:1138 WILMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-2819
Mailing Address - Country:US
Mailing Address - Phone:801-581-2000
Mailing Address - Fax:801-463-0313
Practice Address - Street 1:1138 WILMINGTON AVE
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-2819
Practice Address - Country:US
Practice Address - Phone:801-581-2000
Practice Address - Fax:801-463-0313
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4803532-1205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine