Individual
MARK PEQUIGNOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP FNP
Contact information
Practice address
1700 NW GARDEN VALLEY BLVD STE 201, ROSEBURG, OR 97471-1636
(541) 236-9246
(541) 464-0789
Mailing address
1700 NW GARDEN VALLEY BLVD STE 201, ROSEBURG, OR 97471-1636
(541) 236-9246
(541) 464-0789
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10010332
OR
Other
Enumeration date
05/02/2023
Last updated
03/01/2024
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