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1184749970
JONATHAN C PEACHEY
ESPANOLA, NM
NPI
1184749970
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NM R36036)
Enumeration Date
2007-03-20
Last Update Date
2007-07-08
Business Address
JONATHAN C PEACHEY CFNP
1010 SPRUCE ST ESPANOLA HOSPITAL
ESPANOLA, NM 87532-2724
Phone number: 505-753-7111
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Mailing Address
JONATHAN C PEACHEY CFNP
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-5356
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