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Individual

LISA JO PIERCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MHA, LPN, NHC

Contact information

Practice address
6120 53RD AVE E, BRADENTON, FL 34203-9707
(941) 727-1243
(941) 751-9039
Mailing address
6120 53RD AVE E, BRADENTON, FL 34203-9707
(941) 727-1243
(941) 751-9039

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
164W00000X
Licensed Practical Nurse
Primary
PN1174971
FL

Other

Enumeration date
11/10/2011
Last updated
11/10/2011
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