Provider Demographics
NPI:1265790174
Name:MOORE, KIERSTEN E (CD(DONA))
Entity type:Individual
Prefix:MS
First Name:KIERSTEN
Middle Name:E
Last Name:MOORE
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BENDER DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-3635
Mailing Address - Country:US
Mailing Address - Phone:502-319-0804
Mailing Address - Fax:
Practice Address - Street 1:103 BENDER DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-3635
Practice Address - Country:US
Practice Address - Phone:502-319-0804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula