# PEGGY J. MANCUSO

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

## Provider details

- **NPI number:** 1356407514
- **Gender:** F
- **Credential:** CNM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 367A00000X | Advanced Practice Midwife | 445642 | TX | Yes |

## Other

- **Enumeration date:** 12/29/2006
- **Last updated:** 07/20/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036917501 | — | TX |
| 05 | — | 036917502 | — | TX |