MEDICARE: SALLEY KATHERINE PIERCE PA-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	6719	TN

General Provider Information

NPI Number	:	1164269338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALLEY KATHERINE PIERCE PA-S

Provider Business Mailing Address
First Line	:	3443 DICKERSON PIKE STE 740
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37207-2527
Country	:	US
Telephone Number	:	615-866-9639
Fax Number	:

Provider Business Practice Location Address
First Line	:	3443 DICKERSON PIKE STE 740
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37207-2527
Country	:	US
Telephone Number	:	615-866-9639
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2024
Last Update Date	:	01/06/2026

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