Provider Demographics
NPI:1336890680
Name:TWESTEN, SIERRA NICOLE
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:NICOLE
Last Name:TWESTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8025 WINSDALE ST N
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-3953
Mailing Address - Country:US
Mailing Address - Phone:763-370-6014
Mailing Address - Fax:
Practice Address - Street 1:8025 WINSDALE ST N
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-3953
Practice Address - Country:US
Practice Address - Phone:763-370-6014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist