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1295475788
KIRSTEN MICAELA KETCHERSID
DALLAS, TX
NPI
1295475788
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: TX 1019995)
Enumeration Date
2022-03-31
Last Update Date
2022-03-31
Business Address
KIRSTEN MICAELA KETCHERSID
12895 JOSEY LN STE 114
DALLAS, TX 75234-8300
Phone number: 972-532-9967
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Mailing Address
KIRSTEN MICAELA KETCHERSID
14100 SAN PEDRO AVE STE 412
SAN ANTONIO, TX 78232-2009
Phone number: 210-281-8669
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