Provider Demographics
NPI:1831231596
Name:PIERCEY, ANDREA L (ARNP)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:L
Last Name:PIERCEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:D
Other - Last Name:LEIGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:7855 ARGYLE FOREST BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-5596
Mailing Address - Country:US
Mailing Address - Phone:904-282-6331
Mailing Address - Fax:904-282-4117
Practice Address - Street 1:421 KINGSLEY AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4897
Practice Address - Country:US
Practice Address - Phone:904-264-8801
Practice Address - Fax:904-621-0566
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2954732363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00847540OtherMEDICARE RAILROAD
FLP00847540OtherMEDICARE RAILROAD