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General NPI Number Information
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NPI Number | 1801429709
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Entity Type | Individual
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Provider Name | BREYUNNA JALYN PIERCE RN
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Gender | Female
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1089 XRAY DR
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City | GASTONIA
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State | NC
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Zip | 28054
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Country | US
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Telephone | 828-707-0409
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Fax |
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Provider Business Mailing Address
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Address Line | 9715 BACK ACRE DR
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City | CHARLOTTE
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State | NC
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Zip | 28213-4840
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Country | US
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Telephone | 419-283-7930
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 470528
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 344452
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License Number State | NC
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