Individual
MRS. KATHLEEN JO PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, RN
Contact information
Practice address
7301 GARLAND AVE, TAKOMA PARK, MD 20912-6417
(301) 807-5605
Mailing address
600 ELM AVE, TAKOMA PARK, MD 20912-5432
(301) 807-5605
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
R186240
MD
367A00000X
Advanced Practice Midwife
RN1034066
DC
Other
Enumeration date
11/09/2009
Last updated
03/07/2017
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