Individual
CARISSA PIERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5447 MAPLE LN STE A, FAYETTEVILLE, WV 25840-6872
(304) 574-1411
Mailing address
5447 MAPLE LN STE A, FAYETTEVILLE, WV 25840-6872
(304) 574-1411
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
39033
WV
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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