Provider Demographics
NPI:1457898934
Name:PIERSON-RYE, CHANDRA ANISHA (DNP FNP-BC PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CHANDRA
Middle Name:ANISHA
Last Name:PIERSON-RYE
Suffix:
Gender:F
Credentials:DNP FNP-BC PMHNP-BC
Other - Prefix:
Other - First Name:CHANDRA
Other - Middle Name:ANISHA
Other - Last Name:PIERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 19248
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62794-9248
Mailing Address - Country:US
Mailing Address - Phone:217-528-7541
Mailing Address - Fax:
Practice Address - Street 1:2120 N 27TH ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-2191
Practice Address - Country:US
Practice Address - Phone:217-528-7541
Practice Address - Fax:888-428-7891
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.338520163W00000X
IL209.015433363LF0000X
IL277.000526363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health