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General NPI Number Information
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NPI Number | 1922431303
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Entity Type | Individual
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Provider Name | KIMBERLEE ALISON PIERCE PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/20/2013
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 4156 MANZANITA AVE
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City | CARMICHAEL
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State | CA
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Zip | 95608-1496
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Country | US
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Telephone | 916-488-6337
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Fax |
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Provider Business Mailing Address
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Address Line | 7550 FOLSOM AUBURN RD APT 816
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City | FOLSOM
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State | CA
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Zip | 95630-1769
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Country | US
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Telephone | 302-354-4758
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA23061
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License Number State | CA
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