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1811394828
ALICIA NICOLE PEACOCK
GALLUP, NM
NPI
1811394828
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2100X Nurse Practitioner Acute Care
(Licence: NM CNP-02574)
Enumeration Date
2014-11-20
Last Update Date
2015-09-11
Business Address
ALICIA NICOLE PEACOCK FNP
1850 EAST HWY 66
GALLUP, NM 87301
Phone number: 505-918-4602
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Mailing Address
ALICIA NICOLE PEACOCK FNP
PO BOX 2956
FARMINGTON, NM 87401
Phone number: 505-918-4601
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