Provider Demographics
NPI:1255843660
Name:YEH, KIRSTEN TARA (PNP)
Entity type:Individual
Prefix:MS
First Name:KIRSTEN
Middle Name:TARA
Last Name:YEH
Suffix:
Gender:
Credentials:PNP
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Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-454-6051
Mailing Address - Fax:314-454-6225
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:DIV PED ENDOCRINOLOGY AND DIABETES
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6051
Practice Address - Fax:314-454-6225
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2025-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2021010431363LP0200X
PASP0170902080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420099359Medicaid