Individual
MS. PEGGY L PERDUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MA
Contact information
Practice address
600 TRACY WAY, CHARLESTON, WV 25311-1223
(304) 388-2964
(304) 399-4968
Mailing address
600 TRACY WAY, CHARLESTON, WV 25311-1262
(304) 388-4965
(304) 343-4850
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
782
WV
163W00000X
Registered Nurse
40151
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001782254
MOUNTAIN STATE BC/BS
WV
05
—
3810004165
—
WV
Enumeration date
10/25/2006
Last updated
05/22/2012
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