Provider Demographics
NPI:1750064648
Name:PIERCE, HOLLY
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 GROVER RD
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:OH
Mailing Address - Zip Code:45620-9582
Mailing Address - Country:US
Mailing Address - Phone:740-645-6258
Mailing Address - Fax:
Practice Address - Street 1:307 GROVER RD
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:OH
Practice Address - Zip Code:45620-9582
Practice Address - Country:US
Practice Address - Phone:740-645-6258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0034514363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health