| NPI | 1538563028 |
|---|---|
| Former Name | DANA PEACOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11003137) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MD P180866) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024174554) | |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2022-07-21 |