Provider Demographics
NPI:1053024570
Name:PIERCE, HANNAH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:NG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1260 DOCTORS LN STE A
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4072
Mailing Address - Country:US
Mailing Address - Phone:970-286-2668
Mailing Address - Fax:
Practice Address - Street 1:1715 IRON HORSE DR STE 104
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-9756
Practice Address - Country:US
Practice Address - Phone:970-286-2668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-29
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical