Healthcare Provider Details

I. General information

NPI: 1619014545
Provider Name (Legal Business Name): LYNN SUE PIERCE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 BENNETT AVE
OAKFIELD NY
14125-1102
US

IV. Provider business mailing address

1 LINCOLN AVE
BATAVIA NY
14020-2012
US

V. Phone/Fax

Practice location:
  • Phone: 585-948-5464
  • Fax:
Mailing address:
  • Phone: 585-343-1469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number284425-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: