Provider Demographics
NPI:1669655148
Name:DEBORAH L. PIERCE, ARNP, PA
Entity Type:Organization
Organization Name:DEBORAH L. PIERCE, ARNP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:727-846-0467
Mailing Address - Street 1:6133 OAK RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-4234
Mailing Address - Country:US
Mailing Address - Phone:727-846-0467
Mailing Address - Fax:727-816-9745
Practice Address - Street 1:1938 SOULE RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1507
Practice Address - Country:US
Practice Address - Phone:727-726-7442
Practice Address - Fax:727-288-1111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303010500Medicaid
FL303010500Medicaid