Provider Demographics
NPI:1033602834
Name:PIERCE, JENA LEANNA (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JENA
Middle Name:LEANNA
Last Name:PIERCE
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 TRAFALGAR DR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-2228
Mailing Address - Country:US
Mailing Address - Phone:228-860-0120
Mailing Address - Fax:
Practice Address - Street 1:1613 23RD AVE
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501
Practice Address - Country:US
Practice Address - Phone:228-284-4651
Practice Address - Fax:228-284-4636
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902707363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health