Individual
JACKIE PIERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
7959 STATE ROUTE 124, LATHAM, OH 45646-9701
(740) 493-1800
(740) 493-1500
Mailing address
1735 27TH ST STE B06, PORTSMOUTH, OH 45662-2681
(740) 356-8034
(740) 353-7900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.025524
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0368049
—
OH
Enumeration date
08/28/2019
Last updated
12/17/2020
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