Provider Demographics
NPI:1831822386
Name:PIERCE HEALTHCARE SOLUTIONS
Entity type:Organization
Organization Name:PIERCE HEALTHCARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HIBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-353-4622
Mailing Address - Street 1:11217 HIGHWAY 421 S
Mailing Address - Street 2:
Mailing Address - City:TYNER
Mailing Address - State:KY
Mailing Address - Zip Code:40486-8352
Mailing Address - Country:US
Mailing Address - Phone:859-353-4622
Mailing Address - Fax:
Practice Address - Street 1:104 JOHN ST STE B06
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1600
Practice Address - Country:US
Practice Address - Phone:859-302-6752
Practice Address - Fax:606-712-1200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-01
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty