Provider Demographics
NPI:1316183213
Name:PIERSON, THOMAS LAMAR (CRNA)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:LAMAR
Last Name:PIERSON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 FORD CIR
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-1115
Mailing Address - Country:US
Mailing Address - Phone:239-849-2336
Mailing Address - Fax:239-369-1232
Practice Address - Street 1:1435 FORD CIR
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-1115
Practice Address - Country:US
Practice Address - Phone:239-849-2336
Practice Address - Fax:239-369-1232
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9272239367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered