Provider Demographics
NPI:1134347677
Name:PIERCE, LYNNE ELAINE (OD)
Entity type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:ELAINE
Last Name:PIERCE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1399 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:YORK SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17372-9021
Mailing Address - Country:US
Mailing Address - Phone:717-432-2298
Mailing Address - Fax:
Practice Address - Street 1:1155 CARLISLE ST
Practice Address - Street 2:SUITE 20
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1200
Practice Address - Country:US
Practice Address - Phone:717-637-2561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001312152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT30559Medicare UPIN
PAPI460239Medicare ID - Type Unspecified