| Doctor Name: | SUZANNE PEDDICORD |
| NPI Number: | 1063667277 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, BSN |
| License Number: | 67861 |
| Business Practice Address: | 300 Preston Dr Kingwood, WV - 265371551 |
| Business Phone Number: | 3046246554 |
| Business Fax Number: | 3046245223 |
| Mailing Address: | 300 Preston Dr, KINGWOOD |
| State: | WV |
| Postal Code: | 265371551 |
| Phone Number: | 3046246554 |
| Fax Number: | 3046245223 |
| NPI Enumeration Date: | 12/02/2008 |
| NPI Last Update Date: | 12/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 67861 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |