Healthcare Provider Details

I. General information

NPI: 1710874326
Provider Name (Legal Business Name): DELORES MARIE PIERCE REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 MICHELINE TER
RICHMOND VA
23223-2216
US

IV. Provider business mailing address

1004 MICHELINE TER
RICHMOND VA
23223-2216
US

V. Phone/Fax

Practice location:
  • Phone: 804-437-2509
  • Fax:
Mailing address:
  • Phone: 804-437-2509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number0001188173
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: