Provider Demographics
NPI:1982422770
Name:PIERCY, NICOLE DRUCKER (PA-C)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:DRUCKER
Last Name:PIERCY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 N ARTHUR ASHE BLVD APT 3
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-3306
Mailing Address - Country:US
Mailing Address - Phone:757-373-3660
Mailing Address - Fax:
Practice Address - Street 1:425 N ARTHUR ASHE BLVD APT 3
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-3306
Practice Address - Country:US
Practice Address - Phone:757-373-3660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA011010239363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical