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NPI Code Detail

MEDICARE: STACEY L PIERCE PA-C

MEDICARE: STACEY L PIERCE PA-C
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
1363A00000XPhysician AssistantMA001198LPA
2363A00000XPhysician AssistantOA002426PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112082426OTHERCAQH
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376501601
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY L PIERCE PA-C
Provider Business Mailing Address
First Line : 1629 UNION AVE STE 4
Second Line :
City : NATRONA HEIGHTS
State : PA
Zip : 15065-2134
Country : US
Telephone Number : 724-671-1161
Fax Number : 724-671-1170
Provider Business Practice Location Address
First Line : 1629 UNION AVE STE 4
Second Line :
City : NATRONA HEIGHTS
State : PA
Zip : 15065-2134
Country : US
Telephone Number : 724-671-1161
Fax Number : 724-671-1170
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 10/06/2020

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Directions to “ STACEY L PIERCE PA-C” Practice Location

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