Provider Demographics
NPI:1972004125
Name:PIERCE, MISTY ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:ANN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 COUNTY ROAD 4790
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75494-7617
Mailing Address - Country:US
Mailing Address - Phone:903-975-5429
Mailing Address - Fax:
Practice Address - Street 1:800 COUNTY ROAD 4790
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:TX
Practice Address - Zip Code:75494-7617
Practice Address - Country:US
Practice Address - Phone:903-975-5429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX790552163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse