MEDICARE: CORRIE VIRGINIA ST. PIERRE AGACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	AP126899	TX

General Provider Information

NPI Number	:	1881090173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORRIE VIRGINIA ST. PIERRE AGACNP

Provider Business Mailing Address
First Line	:	121 NW NEWTON DR
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-4777
Country	:	US
Telephone Number	:	817-615-8840
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 NW NEWTON DR
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-4777
Country	:	US
Telephone Number	:	817-615-8840
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2014
Last Update Date	:	03/06/2026

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