Individual
PEGGY KIM MART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4324 S 214TH ST, ELKHORN, NE 68022-3358
(402) 707-5646
Mailing address
4324 S 214TH ST, ELKHORN, NE 68022-3358
(402) 707-5646
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
36948
NE
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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