Provider Demographics
NPI:1194131136
Name:PEARCE, CARSON WILLIAM (CRNP)
Entity type:Individual
Prefix:
First Name:CARSON
Middle Name:WILLIAM
Last Name:PEARCE
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 BERKLEY HILLS DR W
Mailing Address - Street 2:
Mailing Address - City:SOUTHSIDE
Mailing Address - State:AL
Mailing Address - Zip Code:35907-8037
Mailing Address - Country:US
Mailing Address - Phone:256-393-3648
Mailing Address - Fax:
Practice Address - Street 1:21 BILL ROBISON PKWY
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36206-2624
Practice Address - Country:US
Practice Address - Phone:256-240-0824
Practice Address - Fax:256-240-0825
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-089265363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily