# AMANDA DAWN PEACOCK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1134406184
- **Gender:** F
- **Credential:** ANP-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | H-120679 | IA | — |
| 363LG0600X | Gerontology Nurse Practitioner | J120679 | IA | — |
| 364SA2200X | Adult Health Clinical Nurse Specialist | 95004519 | CA | Yes |

## Other

- **Enumeration date:** 11/04/2011
- **Last updated:** 12/10/2016