Peacock, Joan Marie
Peacock, Joan Marie is an individual health care provider with primary practice located at 6100 Pan American Freeway Ne Ste 450 , Albuquerque NM 87109-3460. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Peacock, Joan Marie can be contacted via phone (505) 823-8787.Contact Information
Primary practice address
6100 Pan American Freeway Ne Ste 450
Albuquerque NM 87109-3460
Phone: (505) 823-8787
Fax: (505) 823-8788
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 364SW0102X | R56766 | New Mexico |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | CNP01354 | New Mexico |
Profile Details
| NPI number | 1619963824 |
|---|---|
| LBN Legal business name | Peacock, Joan Marie |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 22nd, 2005 |
| Last updated | Mar 17th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619963824 | NPPES |
| New Mexico | MEDICAID | 000271730 | |
| New Mexico | MEDICAID | 66175526 |
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