Individual
PEGGY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 458-8899
Mailing address
PO BOX 220, ROLLA, MO 65402-0220
(573) 458-8899
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
200318322
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003018322
LICENSE
MO
Enumeration date
12/18/2009
Last updated
12/18/2009
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