Provider Demographics
NPI:1356043426
Name:PIEROTTI, SUELY M (LPN)
Entity type:Individual
Prefix:
First Name:SUELY
Middle Name:M
Last Name:PIEROTTI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SUELY
Other - Middle Name:M
Other - Last Name:PIEROTTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:200 TECH CENTER DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-2747
Mailing Address - Country:US
Mailing Address - Phone:865-637-9711
Mailing Address - Fax:
Practice Address - Street 1:5310 BALL CAMP PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-3234
Practice Address - Country:US
Practice Address - Phone:865-523-4704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN100125164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse