Provider Demographics
NPI:1316960164
Name:PIERCE, ALEXANDRA D (PA)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:D
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1250 S CLEARVIEW AVE STE 100
Mailing Address - Street 2:URGENT CARE EXTRA
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-3378
Mailing Address - Country:US
Mailing Address - Phone:480-988-9108
Mailing Address - Fax:480-813-4460
Practice Address - Street 1:641 W WARNER RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-7266
Practice Address - Country:US
Practice Address - Phone:480-722-9828
Practice Address - Fax:480-722-9831
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY236363AM0700X
AZ3200363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ537076Medicaid
S84386Medicare UPIN