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Individual

MRS. PEGGY ANN WOLPERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-5383
(217) 554-4807
Mailing address
1900 E MAIN ST # 11C, DANVILLE, IL 61832-5100
(217) 554-3000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
209008961
IL
363L00000X
Nurse Practitioner
Primary
71007712A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300010497
IN
01
71007712A
INDIANA LICENSE
IN
Enumeration date
10/04/2011
Last updated
05/15/2019
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