Provider Demographics
NPI:1558250613
Name:PIERCE, CHARLENE M
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:M
Last Name:PIERCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5353 N 34TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-1636
Mailing Address - Country:US
Mailing Address - Phone:402-210-6501
Mailing Address - Fax:
Practice Address - Street 1:5353 N 34TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-1636
Practice Address - Country:US
Practice Address - Phone:402-210-6501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion