Provider Demographics
NPI:1255768644
Name:PIERCE, STEPHANIE MARIE (PA)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MARIE
Last Name:PIERCE
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Gender:F
Credentials:PA
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Mailing Address - Street 1:6600 E 2ND ST
Mailing Address - Street 2:CENTRAL WYOMING NEUROSURGERY
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-4348
Mailing Address - Country:US
Mailing Address - Phone:307-266-4000
Mailing Address - Fax:307-473-6793
Practice Address - Street 1:6600 E 2ND ST
Practice Address - Street 2:CENTRAL WYOMING NEUROSURGERY
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609
Practice Address - Country:US
Practice Address - Phone:307-266-4000
Practice Address - Fax:307-473-6793
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2018-08-16
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Provider Licenses
StateLicense IDTaxonomies
COPA.0001733363AS0400X
WYTL581363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical