Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | R 080995-5 | MN |
NPI | 1053374249 |
---|---|
Provider Name | Nancy Jean Pierro |
First Address | Minneapolis, MN 55440-0043 |
Second Address | Elk River, MN 55330-4654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 13/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
590742000 | (05) | MN |
P16480 | (02) |