Provider Demographics
NPI:1184785826
Name:PIERCE, JANE SHELBY (MSN)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:SHELBY
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 W MAIN ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-1323
Mailing Address - Country:US
Mailing Address - Phone:615-444-1880
Mailing Address - Fax:615-444-7411
Practice Address - Street 1:1432 W MAIN ST
Practice Address - Street 2:SUITE 700
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-1323
Practice Address - Country:US
Practice Address - Phone:615-444-1880
Practice Address - Fax:615-444-7411
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006033363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3644777Medicaid
TNP00395512OtherRAILROAD MEDICARE
TN3644777Medicaid