Healthcare Provider Details

I. General information

NPI: 1245473578
Provider Name (Legal Business Name): HOWARD SHANE PIERCE R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2009
Last Update Date: 04/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 TANNER WILLIAMS RD
MOBILE AL
36608-8322
US

IV. Provider business mailing address

8501 TANNER WILLIAMS RD
MOBILE AL
36608-8322
US

V. Phone/Fax

Practice location:
  • Phone: 251-441-6113
  • Fax: 251-441-6415
Mailing address:
  • Phone: 251-441-6113
  • Fax: 251-441-6415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number1-113335
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License Number1-113335
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: