Individual
MS. PEGGY ELOISE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP-C
Contact information
Practice address
1200 HILYARD ST STE 450, EUGENE, OR 97401-8164
(458) 205-7131
(541) 687-6214
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
(360) 729-1253
(360) 729-3185
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201804601NP-PP
OR
363L00000X
Nurse Practitioner
APRN002061
NV
363LF0000X
Family Nurse Practitioner
CNP-02348
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235553801
—
NV
Enumeration date
02/18/2014
Last updated
08/17/2018
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