Healthcare Provider Details

I. General information

NPI: 1255767448
Provider Name (Legal Business Name): NANCY MARINETTE RIERSON MSN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 MOCKSVILLE AVE
SALISBURY NC
28144-2732
US

IV. Provider business mailing address

166 LAUREL CREEK DR
MOUNT AIRY NC
27030-1904
US

V. Phone/Fax

Practice location:
  • Phone: 704-210-5000
  • Fax:
Mailing address:
  • Phone: 336-783-0728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number100965
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1852
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: