Pierce, Jennifer Kay

Pierce, Jennifer Kay is an individual health care provider with primary practice located at 721 River Drive Suite A, Fort Bragg CA 95437-5403. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Pierce, Jennifer Kay can be contacted via phone (707) 961-4631.

Contact Information

Primary practice address
721 River Drive Suite A Fort Bragg CA 95437-5403
Phone: (707) 961-4631
Fax: (707) 964-1192
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X MA052907 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X OA003207 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 53318 California

Profile Details

NPI number 1538394713
LBN Legal business name Pierce, Jennifer Kay
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2009
Last updated Jan 24th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538394713 NPPES
Arizona MEDICAID 433019
Arizona MEDICAID 48670880

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