Individual
CRISTAL KAYE PEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2121A BELLEVUE RD, DUBLIN, GA 31021-2998
(478) 275-6813
(478) 274-7628
Mailing address
2121A BELLEVUE RD, DUBLIN, GA 31021-2998
(478) 275-6813
(478) 274-7628
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN075613
GA
Other
Enumeration date
04/26/2012
Last updated
04/26/2012
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