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Individual

MRS. CAROL I PEAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
5830 WOODROW DR, SYLVANIA, OH 43560-1245
(419) 481-3493
Mailing address
5830 WOODROW DR, SYLVANIA, OH 43560-1245
(419) 481-3493

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704194858 NP-C
MI
363LF0000X
Family Nurse Practitioner
Primary
RN-177161 NP-09813
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1467635664
NPI 1
OH
01
1992015135
CAROL I PEAKE LLC, NPI 2
OH
Enumeration date
12/11/2007
Last updated
11/12/2010
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