Provider Demographics
NPI:1174931695
Name:PIERCE, JENNIFER (DNP-PMHNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:DNP-PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 MILLS SPRING RD STE 6
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MT
Mailing Address - Zip Code:59917-9773
Mailing Address - Country:US
Mailing Address - Phone:406-407-4906
Mailing Address - Fax:
Practice Address - Street 1:99 MILLS SPRING RD STE 6
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917-9773
Practice Address - Country:US
Practice Address - Phone:406-407-4906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT147971363LP0808X, 363LP0808X
AZAP5713363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health