Healthcare Provider Details

I. General information

NPI: 1962276733
Provider Name (Legal Business Name): OLIVIA PIERCE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 EASTPOINT PKWY
LOUISVILLE KY
40223-4112
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 502-975-2960
  • Fax: 502-290-1931
Mailing address:
  • Phone: 502-975-2960
  • Fax: 502-290-1931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4011030
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: