Healthcare Provider Details

I. General information

NPI: 1336205954
Provider Name (Legal Business Name): LADONYA C. PIERCE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 PARK LN
FULTONDALE AL
35068-1915
US

IV. Provider business mailing address

521 PARK LN
FULTONDALE AL
35068-1915
US

V. Phone/Fax

Practice location:
  • Phone: 205-808-9203
  • Fax:
Mailing address:
  • Phone: 205-808-9203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number1-106673
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: