Individual
JUSTIN PAUL PEARCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 MALLARD CREEK RD, SUITE 320, LOUISVILLE, KY 40207-4194
(502) 690-8782
(502) 459-0923
Mailing address
100 MALLARD CREEK RD, SUITE 320, LOUISVILLE, KY 40207-4194
(502) 690-8782
(502) 459-0923
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1118846
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100086990
—
KY
Enumeration date
05/05/2009
Last updated
08/22/2013
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