Provider Demographics
NPI:1104826767
Name:PIERCE, PATRICIA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 PINTO LN
Mailing Address - Street 2:STE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4004
Mailing Address - Country:US
Mailing Address - Phone:702-382-3200
Mailing Address - Fax:702-382-3575
Practice Address - Street 1:2011 PINTO LN
Practice Address - Street 2:STE 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4004
Practice Address - Country:US
Practice Address - Phone:702-382-3200
Practice Address - Fax:702-382-3575
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6358207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0020-19052Medicaid
E81416Medicare UPIN
NV100003Medicare ID - Type Unspecified