Provider Demographics
NPI:1770770372
Name:TIERNEY, JOANN (CFNP)
Entity type:Individual
Prefix:MS
First Name:JOANN
Middle Name:
Last Name:TIERNEY
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 CHURCH ST
Mailing Address - Street 2:MCLA HEALTH SERVICES
Mailing Address - City:N ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-4124
Mailing Address - Country:US
Mailing Address - Phone:413-662-5421
Mailing Address - Fax:413-662-5572
Practice Address - Street 1:375 CHURCH ST
Practice Address - Street 2:MCLA HEALTH SERVICES
Practice Address - City:N ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-4124
Practice Address - Country:US
Practice Address - Phone:413-662-5421
Practice Address - Fax:413-662-5572
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA195591363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner