Provider Demographics
NPI:1255105615
Name:PIERCE, KENNA (BC-HHP, FNC)
Entity type:Individual
Prefix:
First Name:KENNA
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:BC-HHP, FNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2795 E BRIARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-1811
Mailing Address - Country:US
Mailing Address - Phone:435-275-5623
Mailing Address - Fax:
Practice Address - Street 1:2795 E BRIARWOOD DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-1811
Practice Address - Country:US
Practice Address - Phone:435-275-5623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT133N00000X, 171400000X, 174H00000X, 246RP1900X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy