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Individual

PEGGY M. MCCONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
GNP

Contact information

Practice address
207 E MYRTLE AVE, JOHNSON CITY, TN 37601-4633
(423) 926-2500
(423) 926-5999
Mailing address
PO BOX 70403, JOHNSON CITY, TN 37614-1703
(423) 439-4078
(423) 439-4060

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APN005102
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100049918
PHP
TN
05
3903661
TN
01
4102133
BLUECROSSBLUESHIELD
TN
01
TN01E4
JOHN DEERE
TN
Enumeration date
06/27/2006
Last updated
01/23/2008
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