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General NPI Number Information
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NPI Number | 1437957339
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Entity Type | Individual
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Provider Name | KENSHENA PIERCE
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Gender | Female
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 2008 W 119TH ST STE 7
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City | CHICAGO
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State | IL
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Zip | 60643-4818
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Country | US
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Telephone | 708-690-8895
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Fax | 872-762-5326
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Provider Business Mailing Address
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Address Line | 2008 W 119TH ST STE 7
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City | CHICAGO
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State | IL
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Zip | 60643-4818
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Country | US
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Telephone | 708-690-8895
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Fax | 872-762-5326
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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 | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number |
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License Number State | IL
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