Provider Demographics
NPI:1649475427
Name:PEARCE, ANN ELLEN (DPT)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:ELLEN
Last Name:PEARCE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 BENSON DR
Mailing Address - Street 2:STE 222
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7362
Mailing Address - Country:US
Mailing Address - Phone:919-871-5811
Mailing Address - Fax:
Practice Address - Street 1:3301 BENSON DR
Practice Address - Street 2:STE 222
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7362
Practice Address - Country:US
Practice Address - Phone:919-871-5811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2015-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11088225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC068G9OtherBCBS
NC2504161AMedicare PIN
NC2504161AMedicare PIN