Healthcare Provider Details

I. General information

NPI: 1578542270
Provider Name (Legal Business Name): MARY FRANCES PIERCY CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 06/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 INDIANA AVE
WINSLOW AZ
86047-2169
US

IV. Provider business mailing address

500 INDIANA AVE
WINSLOW AZ
86047-2169
US

V. Phone/Fax

Practice location:
  • Phone: 928-289-4646
  • Fax:
Mailing address:
  • Phone: 928-289-4646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.002075
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: