Provider Demographics
NPI:1891781308
Name:PIERCE, JULIANNE D (ANP)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:D
Last Name:PIERCE
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 1:3008 OVERLAND TRL
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-4522
Mailing Address - Country:US
Mailing Address - Phone:903-814-0548
Mailing Address - Fax:
Practice Address - Street 1:3008 OVERLAND TRL
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-4522
Practice Address - Country:US
Practice Address - Phone:903-814-0548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ071833363LA2200X
TXAP126559363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX342314701Medicaid
OK200568940AMedicaid
TX342314701Medicaid
TX387571YSYFMedicare PIN
AZZ138975Medicare PIN
AZZ68782Medicare PIN