Individual
MRS. PEGGY FOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
48 MEDICAL PARK DR E STE 355, BIRMINGHAM, AL 35235-3470
(205) 838-3036
(205) 838-5832
Mailing address
750 PETER BRYCE BLVD, TUSCALOOSA, AL 35401-7456
(205) 348-6262
(205) 348-4121
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
041333443
IL
363L00000X
Nurse Practitioner
209004753
IL
363LF0000X
Family Nurse Practitioner
Primary
0371998
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-166208
BLUE CROSS
AL
Enumeration date
10/06/2006
Last updated
02/04/2022
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