Individual
PEGGY L SEGURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
38935 ANN ARBOR RD, LIVONIA, MI 48150-3397
(734) 632-0175
(734) 632-0182
Mailing address
10000 TELEGRAPH RD, EMERGENCY DEPT., TAYLOR, MI 48180-3330
(313) 295-5007
(313) 295-6725
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704240002
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704240002
MEDICAL LICENSE
MI
01
—
PENDING
CAQH
MI
05
—
PENDING
—
MI
Enumeration date
10/26/2011
Last updated
10/26/2011
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