Individual
LAURA FAYE PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
770 PARK EAST BLVD STE B, LAFAYETTE, IN 47905
(765) 714-4344
Mailing address
PO BOX 5748, LAFAYETTE, IN 47903-5748
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71006726A
IN
Other
Enumeration date
11/29/2016
Last updated
12/18/2020
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