Provider Demographics
NPI:1114919115
Name:PIERCY, NANCY J (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:J
Last Name:PIERCY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 UPPER CHESAPEAKE DR
Mailing Address - Street 2:SUITE 308
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4339
Mailing Address - Country:US
Mailing Address - Phone:443-643-4800
Mailing Address - Fax:443-643-4801
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 308
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4339
Practice Address - Country:US
Practice Address - Phone:443-643-4800
Practice Address - Fax:443-643-4801
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR107561363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD449800300Medicaid
S71325Medicare UPIN
S71325Medicare UPIN
MD120236OtherJHHC PROVIDER NUMBER
MD449800300Medicaid
MD500001206OtherRR MEDICARE
MD7605-0023OtherCAREFIRST BLUECHOICE