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NPI Code Detail

MEDICARE: MRS. JANA LYNN PIERCE CNP

MEDICARE: MRS. JANA LYNN PIERCE CNP
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
1363LF0000XFamily Nurse PractitionerR 155716-7MN

General Provider Information

NPI Number : 1902886849
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANA LYNN PIERCE CNP
Provider Business Mailing Address
First Line : 2078 VINING DR
Second Line : UNIT L
City : WOODBURY
State : MN
Zip : 55125-7562
Country : US
Telephone Number : 913-486-5566
Fax Number :
Provider Business Practice Location Address
First Line : 3633 BUNKER LAKE BLVD NW
Second Line :
City : ANDOVER
State : MN
Zip : 55304-7402
Country : US
Telephone Number : 763-421-5011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 07/08/2007

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