Doctor Name: | MRS. PEGGY ANN WALTERS |
NPI Number: | 1851379382 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN FNP |
License Number: | 71002258A |
Business Practice Address: | 7 E Main St Gosport, IN - 47433 |
Business Phone Number: | 8128794222 |
Business Fax Number: | 8128794834 |
Mailing Address: | 7 East Main Street, GOSPORT |
State: | IN |
Postal Code: | 474330009 |
Phone Number: | 8128794222 |
Fax Number: | 8128794834 |
NPI Enumeration Date: | 01/05/2006 |
NPI Last Update Date: | 07/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 71002258A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |