Provider Demographics
NPI:1396792107
Name:PIERSMA, IRENE LYNN (RN)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:LYNN
Last Name:PIERSMA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 HOARD ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-4953
Mailing Address - Country:US
Mailing Address - Phone:608-280-0851
Mailing Address - Fax:
Practice Address - Street 1:2314 HOARD ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-4953
Practice Address - Country:US
Practice Address - Phone:608-280-0851
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI85938-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse