Provider Demographics
NPI:1396157533
Name:PIERSON, DEAN THOMAS (RN)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:THOMAS
Last Name:PIERSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 E STERNBERG RD
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49441-6047
Mailing Address - Country:US
Mailing Address - Phone:231-747-6171
Mailing Address - Fax:231-747-6171
Practice Address - Street 1:575 E STERNBERG RD
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-6047
Practice Address - Country:US
Practice Address - Phone:231-747-6171
Practice Address - Fax:231-747-6171
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704266929163W00000X
TX667401163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse