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General NPI Number Information
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NPI Number | 1083441018
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Entity Type | Individual
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Provider Name | SHONTEL K PIERCE PMHNP- BC
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Gender | Female
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Dates
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Enumeration Date | 09/16/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 2273 S EASON BLVD
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City | TUPELO
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State | MS
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Zip | 38804-5900
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Country | US
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Telephone | 662-842-2461
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Fax |
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Provider Business Mailing Address
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Address Line | 110 JUNIPER CT
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City | TUPELO
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State | MS
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Zip | 38801-1203
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Country | US
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Telephone | 662-251-3676
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 907021
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 163WG0600X
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Taxonomy Name | Gerontology Registered Nurse
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License Number | 910047
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 910047
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 910047
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 910047
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License Number State | MS
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Taxonomy #6
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 910047
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License Number State | MS
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