Provider Demographics
NPI:1326300542
Name:PIERSON, RACHEL NICHOLE (RN)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:NICHOLE
Last Name:PIERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 CHINKAPIN RILL
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-8781
Mailing Address - Country:US
Mailing Address - Phone:810-496-5036
Mailing Address - Fax:810-496-4929
Practice Address - Street 1:808 S GRAND TRAVERSE ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502
Practice Address - Country:US
Practice Address - Phone:810-496-5036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704287547163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse