Provider Demographics
NPI:1528570256
Name:PIERCE, LYNDIE MARY-JEAN
Entity Type:Individual
Prefix:
First Name:LYNDIE
Middle Name:MARY-JEAN
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 1:10190 HACIENDA DR
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-5200
Mailing Address - Country:US
Mailing Address - Phone:219-308-9711
Mailing Address - Fax:
Practice Address - Street 1:414 E BROWNSTONE DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47408-2016
Practice Address - Country:US
Practice Address - Phone:219-308-9711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer