Provider Demographics
NPI:1811336555
Name:PIERCE, KAREN (CPM)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 W BROADWAY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54451-1307
Mailing Address - Country:US
Mailing Address - Phone:715-965-9255
Mailing Address - Fax:
Practice Address - Street 1:811 W BROADWAY AVE STE A
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:WI
Practice Address - Zip Code:54451-1307
Practice Address - Country:US
Practice Address - Phone:715-965-9255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-16
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife