Provider Demographics
NPI:1477239143
Name:JESSICA ROBERTS PIERCE PLLC
Entity Type:Organization
Organization Name:JESSICA ROBERTS PIERCE PLLC
Other - Org Name:PIERCE PRIVATE PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ROBERTS
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:334-203-4310
Mailing Address - Street 1:101 E COMMERCE STREET
Mailing Address - Street 2:SUITE 117
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-0021
Mailing Address - Country:US
Mailing Address - Phone:334-230-4310
Mailing Address - Fax:888-240-4654
Practice Address - Street 1:11088 PINEAPPLE HWY
Practice Address - Street 2:
Practice Address - City:FOREST HOME
Practice Address - State:AL
Practice Address - Zip Code:36030-5222
Practice Address - Country:US
Practice Address - Phone:334-210-1199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty