Provider Demographics
NPI:1669063194
Name:PIERCE, WHITNIE (RN)
Entity type:Individual
Prefix:
First Name:WHITNIE
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 W ALPINE RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-5681
Mailing Address - Country:US
Mailing Address - Phone:801-888-1123
Mailing Address - Fax:
Practice Address - Street 1:1042 W ALPINE RIDGE CIR
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-5681
Practice Address - Country:US
Practice Address - Phone:801-888-1123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT73413533102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse