Provider Demographics
NPI:1063973675
Name:PEARCE, HALI NICOLE (DO)
Entity type:Individual
Prefix:
First Name:HALI
Middle Name:NICOLE
Last Name:PEARCE
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32505-7552
Mailing Address - Country:US
Mailing Address - Phone:850-436-4630
Mailing Address - Fax:850-332-0891
Practice Address - Street 1:2315 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-7552
Practice Address - Country:US
Practice Address - Phone:850-436-4630
Practice Address - Fax:850-332-0891
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2448207Q00000X
FL20210207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20210OtherMEDICAL LICENSE
AL2448OtherMEDICAL LICENSE
AL261120Medicaid