Provider Demographics
NPI:1174740724
Name:PIERCE, MARIA JO (CNA)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:JO
Last Name:PIERCE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 N LEIGHTON ST
Mailing Address - Street 2:
Mailing Address - City:KENTON
Mailing Address - State:OH
Mailing Address - Zip Code:43326-1240
Mailing Address - Country:US
Mailing Address - Phone:937-243-3521
Mailing Address - Fax:
Practice Address - Street 1:351 N LEIGHTON ST
Practice Address - Street 2:
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-1240
Practice Address - Country:US
Practice Address - Phone:937-243-3521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2674628374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide