Healthcare Provider Details
I. General information
NPI: 1467099242
Provider Name (Legal Business Name): PAIGE ALLYCIA PIER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/29/2019
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 KEN PRATT BLVD STE 120 PMB 1050
LONGMONT CO
80501-8998
US
IV. Provider business mailing address
205 KEN PRATT BLVD STE 120 PMB 1050
LONGMONT CO
80501-8998
US
V. Phone/Fax
- Phone: 720-220-7837
- Fax:
- Phone: 720-220-7837
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0000X |
| Taxonomy | General Practice Registered Nurse |
| License Number | RN.0191304 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WA2000X |
| Taxonomy | Administrator Registered Nurse |
| License Number | 0191304 |
| License Number State | CO |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 0191304 |
| License Number State | CO |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC0400X |
| Taxonomy | Case Management Registered Nurse |
| License Number | RN.0191304 |
| License Number State | CO |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH0200X |
| Taxonomy | Home Health Registered Nurse |
| License Number | 0191304 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: