Provider Demographics
NPI:1184739591
Name:PIERSON, ROSE (ARNP)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:PIERSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1752 LANCASTER RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8101
Mailing Address - Country:US
Mailing Address - Phone:859-626-1924
Mailing Address - Fax:
Practice Address - Street 1:1019 MAJESTIC DR
Practice Address - Street 2:SUITE 210
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1496
Practice Address - Country:US
Practice Address - Phone:859-277-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4951P363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily