Judy Ann Pearce, CFNP
Individual provider Active NPI Family Nurse Practitioner · Ruleville, MS
NPI 1093908121 · NPPES record last updated Jan 26, 2015
Key facts
- NPI
- 1093908121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R784113 (MS)
- Practice address
- 840 N Oak Ave
Ruleville, MS 38771-3227 - Phone
- (662) 756-4024
- Fax
- (662) 756-4023
- NPI assigned
- Aug 22, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R784113 | MS | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R784113 | MS | Yes |
Addresses
Primary practice location
840 N Oak Ave
Ruleville, MS 38771-3227
Mailing address
840 N Oak Ave
Ruleville, MS 38771-3227
Phone (662) 756-4024
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2134191 | Medicaid | LA | |
| 07857865 | Medicaid | MS | |
| 302I507867 | Other | MS | MEDICARE PTAN |
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- Victoria W Peay
- Pamela Perkins
- Lynsey Giachelli Phillips
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All providers in Ruleville, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2015. 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.