Provider Demographics
NPI:1023509965
Name:PIERCE, JUDITH LYNN (APRN)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:LYNN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 NURSERY RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-2319
Mailing Address - Country:US
Mailing Address - Phone:325-398-2933
Mailing Address - Fax:
Practice Address - Street 1:1536 NURSERY RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-2319
Practice Address - Country:US
Practice Address - Phone:352-398-2933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-26
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9243433363LF0000X
FLAPRN9243433363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily