Individual
MS. JAYNE ELLEN PEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
9900 BREN ROAD EAST, MAIL ROUTE MN 008-B213, MINNETONKA, MN 55343
(800) 561-0861
(563) 421-3129
Mailing address
17015 N. 130TH AVE, SUN CITY WEST, AZ 85375
(309) 269-3162
(563) 421-3129
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP7967
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03262
WELLMARK BCBS
IA
05
—
1583450
—
IA
01
—
15939
IOWA MIDLANDS CHOICE
IA
05
—
2583450
—
IA
Enumeration date
06/02/2005
Last updated
09/15/2020
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