Provider Demographics
NPI:1427864750
Name:PIERRE, JUDITH (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:PIERRE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 N BEND ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-3192
Mailing Address - Country:US
Mailing Address - Phone:404-819-1356
Mailing Address - Fax:
Practice Address - Street 1:950 N MAIN ST # 202
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-3064
Practice Address - Country:US
Practice Address - Phone:617-203-2009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1008482363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health