Provider Demographics
NPI:1164927182
Name:PIERCE, DOROTHY MAE
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:MAE
Last Name:PIERCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-3315
Mailing Address - Country:US
Mailing Address - Phone:513-887-0300
Mailing Address - Fax:513-785-4495
Practice Address - Street 1:1430 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-3315
Practice Address - Country:US
Practice Address - Phone:513-887-0300
Practice Address - Fax:513-785-4495
Is Sole Proprietor?:No
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.145698-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse