Provider Demographics
NPI:1558853598
Name:PEARCE, KATIE LEIGH (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:LEIGH
Last Name:PEARCE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:KATIE
Other - Middle Name:LEIGH
Other - Last Name:DOANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:329 FRIENDS LANE
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936-5175
Mailing Address - Country:US
Mailing Address - Phone:843-525-6257
Mailing Address - Fax:843-525-9418
Practice Address - Street 1:329 FRIENDS LANE
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936-5175
Practice Address - Country:US
Practice Address - Phone:843-525-6257
Practice Address - Fax:843-525-9418
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21691207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC21691OtherNURSING LICENSE BOARD