Stephanie Rose Pierdinock, LMT
Individual provider Active NPI Massage Therapist · Jasper, FL
NPI 1003695115 · NPPES record last updated Sep 27, 2023
Key facts
- NPI
- 1003695115
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA91336 (FL)
- Practice address
- 319 5TH Ave SW
Jasper, FL 32052-6003 - Phone
- (904) 460-6681
- NPI assigned
- Sep 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA91336 | FL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA91336 | FL | Yes |
Addresses
Primary practice location
319 5TH Ave SW
Jasper, FL 32052-6003
Mailing address
319 5TH Ave SW
Jasper, FL 32052-6003
Phone (904) 460-6681
Other providers in Jasper, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.