Provider Demographics
NPI:1144985888
Name:COURIER, KEARSTA
Entity type:Individual
Prefix:
First Name:KEARSTA
Middle Name:
Last Name:COURIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KEARSTA
Other - Middle Name:
Other - Last Name:ORNELLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62044-1402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3301 BERRYWOOD DR STE 204
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6517
Practice Address - Country:US
Practice Address - Phone:217-883-9793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021044993225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist