Provider Demographics
NPI:1336483189
Name:PIERCE, AMY (PMHNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 ENTERPRISE DR UNIT 220
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-2033
Mailing Address - Country:US
Mailing Address - Phone:978-961-4297
Mailing Address - Fax:603-696-4579
Practice Address - Street 1:47 ENTERPRISE DR UNIT 220
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-2033
Practice Address - Country:US
Practice Address - Phone:978-961-4297
Practice Address - Fax:603-696-4579
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-17
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60417674363LF0000X, 363LP0808X
AZ246321363LP0808X
NH063659363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily