Healthcare Provider Details

I. General information

NPI: 1811019540
Provider Name (Legal Business Name): CYNTHIA JEAN PIERZALA CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 04/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 PEYTON ST
BARBOURSVILLE WV
25504-2063
US

IV. Provider business mailing address

PO BOX 4190
BARBOURSVILLE WV
25504-4190
US

V. Phone/Fax

Practice location:
  • Phone: 304-697-2035
  • Fax: 304-697-1641
Mailing address:
  • Phone: 304-399-4405
  • Fax: 304-399-2526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number39733
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: