Provider Demographics
NPI:1710232723
Name:FOOTE, MARY PIERCE (DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:PIERCE
Last Name:FOOTE
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:PIERCE
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, FNP-C
Mailing Address - Street 1:306 POMONA DR STE F
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1643
Mailing Address - Country:US
Mailing Address - Phone:336-541-6475
Mailing Address - Fax:336-541-6485
Practice Address - Street 1:306 POMONA DR STE F
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1643
Practice Address - Country:US
Practice Address - Phone:336-541-6475
Practice Address - Fax:336-541-6485
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2024-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704291693363LF0000X
NC5016207363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1003822412OtherBCBSM - BRONSON
MIN54580038 BRONSONMedicare PIN
MI1710232723Medicaid