Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 5010419 | NC |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 251229 | NC |
NPI | 1225525538 |
---|---|
Provider Name | Jessica Marie Pierce |
First Address | Charlotte, NC 28207-1106 |
Second Address | Charlotte, NC 28207-1106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2018 |
Last Update Date | 09/04/2019 |