Provider Demographics
NPI:1811677255
Name:PIERRELUS, MARIE E (RD, LD)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:E
Last Name:PIERRELUS
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 23RD ST SW
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33976-3338
Mailing Address - Country:US
Mailing Address - Phone:239-823-3367
Mailing Address - Fax:
Practice Address - Street 1:419 N 1ST ST
Practice Address - Street 2:
Practice Address - City:IMMOKALEE
Practice Address - State:FL
Practice Address - Zip Code:34142-3150
Practice Address - Country:US
Practice Address - Phone:239-252-7310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6111133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered