Provider Demographics
NPI:1932148194
Name:ST PIERRE, ANNE M (FNP)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:ST PIERRE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1521
Mailing Address - Country:US
Mailing Address - Phone:607-336-2400
Mailing Address - Fax:607-334-5618
Practice Address - Street 1:157 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1521
Practice Address - Country:US
Practice Address - Phone:607-336-2400
Practice Address - Fax:607-334-5618
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY12690764OtherCAQH
NY01857450Medicaid
NYBB8499Medicare ID - Type UnspecifiedUPSTATE