Healthcare Provider Details

I. General information

NPI: 1821162397
Provider Name (Legal Business Name): VICKI C PIERCE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 S JACKSON HWY SUITE 205
SHEFFIELD AL
35660-5777
US

IV. Provider business mailing address

1120 S JACKSON HWY SUITE 205
SHEFFIELD AL
35660-5777
US

V. Phone/Fax

Practice location:
  • Phone: 256-381-6963
  • Fax: 256-381-6018
Mailing address:
  • Phone: 256-381-6963
  • Fax: 256-381-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1-047508
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: