Healthcare Provider Details

I. General information

NPI: 1013802859
Provider Name (Legal Business Name): DAKOTA PIERCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10976 COUNTY ROAD 83
ELBERTA AL
36530-4690
US

IV. Provider business mailing address

778 LIBERTY RD
FLOWOOD MS
39232-9300
US

V. Phone/Fax

Practice location:
  • Phone: 251-493-1000
  • Fax:
Mailing address:
  • Phone: 769-243-6141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-188751
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: