Healthcare Provider Details

I. General information

NPI: 1174506760
Provider Name (Legal Business Name): KATHRYN E. PIERCE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 KOKOPELLI BLVD STE 1
FRUITA CO
81521-3308
US

IV. Provider business mailing address

PO BOX 130
FRUITA CO
81521-0130
US

V. Phone/Fax

Practice location:
  • Phone: 970-858-9894
  • Fax: 970-858-1331
Mailing address:
  • Phone: 970-858-9894
  • Fax: 970-858-1331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number40158
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: