Provider Demographics
NPI:1932490927
Name:PIERSON, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PIERSON
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 1:409 COUNTY ROAD 1845
Mailing Address - Street 2:
Mailing Address - City:GRAPELAND
Mailing Address - State:TX
Mailing Address - Zip Code:75844-7407
Mailing Address - Country:US
Mailing Address - Phone:936-687-2356
Mailing Address - Fax:
Practice Address - Street 1:2661 FM 2054
Practice Address - Street 2:
Practice Address - City:TENNESSEE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75884-5000
Practice Address - Country:US
Practice Address - Phone:903-928-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX670865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily