Individual
MS. PEGGY ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4114 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4315
(253) 564-4157
(253) 220-2491
Mailing address
4114 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4315
(253) 564-4157
(253) 220-2491
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30006974
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20040025-22
FAMILY NURSE PRACTITIONER
—
01
—
AP30006974
ARNP LICENSE NUMBER
WA
01
—
RN00138953
REGISTARED NURSE LICENSE
WA
Enumeration date
01/16/2007
Last updated
07/28/2023
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