Provider Demographics
NPI:1447311345
Name:PIERCE, KATHERINE L (FNP)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:L
Last Name:PIERCE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5290 MILITARY RD
Mailing Address - Street 2:STE #10
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092-1953
Mailing Address - Country:US
Mailing Address - Phone:716-298-0975
Mailing Address - Fax:716-298-0956
Practice Address - Street 1:5290 MILITARY RD
Practice Address - Street 2:STE #10
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092-1953
Practice Address - Country:US
Practice Address - Phone:716-298-0975
Practice Address - Fax:716-298-0956
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF3316761363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
9512382OtherIHA
000560388001OtherCOMM. BLUE BC WNY