Provider Demographics
NPI:1831880244
Name:PIERCE, NICOLE (CMA / PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:CMA / PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7730 ROSWELL RD STE 400
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-4843
Mailing Address - Country:US
Mailing Address - Phone:678-239-4046
Mailing Address - Fax:
Practice Address - Street 1:7730 ROSWELL RD STE 400
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-4843
Practice Address - Country:US
Practice Address - Phone:678-239-4046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QH0100X
GA11D2284596291U00000X
PTC-8786246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No291U00000XLaboratoriesClinical Medical Laboratory
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy