Provider Demographics
NPI:1881567956
Name:PIERCE, OPAL MARIE
Entity type:Individual
Prefix:
First Name:OPAL
Middle Name:MARIE
Last Name:PIERCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1490 S BURNETT RD APT G
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-3453
Mailing Address - Country:US
Mailing Address - Phone:937-830-9451
Mailing Address - Fax:
Practice Address - Street 1:1490 S BURNETT RD APT G
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-3453
Practice Address - Country:US
Practice Address - Phone:937-830-9451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-25
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker