Provider Demographics
NPI:1689490187
Name:PIERCE, CATHERINE JEAN (RN)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:JEAN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-3525
Mailing Address - Country:US
Mailing Address - Phone:423-588-9978
Mailing Address - Fax:423-722-3401
Practice Address - Street 1:102 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-3525
Practice Address - Country:US
Practice Address - Phone:423-588-9978
Practice Address - Fax:423-722-3401
Is Sole Proprietor?:No
Enumeration Date:2024-11-29
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000114658163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)