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General NPI Number Information
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NPI Number | 1790452977
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Entity Type | Individual
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Provider Name | IAN MICHEAL PIERCE APRN
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Gender | Male
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 529 PINNACLE DR
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City | PAPILLION
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State | NE
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Zip | 68046-6242
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Country | US
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Telephone | 402-268-1212
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Fax | 402-502-9177
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Provider Business Mailing Address
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Address Line | 529 PINNACLE DR
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City | PAPILLION
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State | NE
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Zip | 68046-6242
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Country | US
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Telephone | 402-268-1212
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Fax | 402-502-9177
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 113771
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 113771
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License Number State | NE
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