Provider Demographics
NPI:1407688906
Name:PIERCE, MARGUERITE AMELIA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:AMELIA
Last Name:PIERCE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PERU RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:NY
Mailing Address - Zip Code:13073-1244
Mailing Address - Country:US
Mailing Address - Phone:607-898-5803
Mailing Address - Fax:607-898-3130
Practice Address - Street 1:400 PERU RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:NY
Practice Address - Zip Code:13073-1244
Practice Address - Country:US
Practice Address - Phone:607-898-5803
Practice Address - Fax:607-898-3130
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY631301-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse