Lively, Peggy Yvonne

Lively, Peggy Yvonne is an individual health care provider with primary practice located at 1120 Glenns Bay Rd , Surfside Beach SC 29575-4757. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Lively, Peggy Yvonne can be contacted via phone (843) 215-5492.

Contact Information

Primary practice address
1120 Glenns Bay Rd Surfside Beach SC 29575-4757
Phone: (843) 215-5492
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3938 South Carolina

Profile Details

NPI number 1033239678
LBN Legal business name Lively, Peggy Yvonne
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2007
Last updated Sep 12th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033239678 NPPES
South Carolina MEDICAID NP1563

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