Provider Demographics
NPI:1679646194
Name:PIERS, SHERI L (ANP)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:L
Last Name:PIERS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 FOREST AVENUE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103
Mailing Address - Country:US
Mailing Address - Phone:207-797-0113
Mailing Address - Fax:207-797-7870
Practice Address - Street 1:1250 FOREST AVENUE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103
Practice Address - Country:US
Practice Address - Phone:207-797-0113
Practice Address - Fax:207-797-7870
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERO36663363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME232048768OtherBCBS
ME254290001Medicaid
ME232048768OtherBCBS
ME254290001Medicaid