Provider Demographics
NPI:1093453110
Name:BIERL, TESS (PA)
Entity Type:Individual
Prefix:MISS
First Name:TESS
Middle Name:
Last Name:BIERL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4389 BEAUFORT RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4389 BEAUFORT RD
Practice Address - Street 2:
Practice Address - City:CHERRY POINT
Practice Address - State:NC
Practice Address - Zip Code:28533
Practice Address - Country:US
Practice Address - Phone:252-466-0921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028228207QA0505X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine