Provider Demographics
NPI:1982385118
Name:PIERCE, CAMRYN JANE
Entity Type:Individual
Prefix:
First Name:CAMRYN
Middle Name:JANE
Last Name:PIERCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4012 RIDGEPOINTE CV
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-6870
Mailing Address - Country:US
Mailing Address - Phone:678-314-1057
Mailing Address - Fax:
Practice Address - Street 1:4012 RIDGEPOINTE CV
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-6870
Practice Address - Country:US
Practice Address - Phone:678-314-1057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program