Individual
PEGGY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1993 WENTZVILLE PKWY, WENTZVILLE, MO 63385-3424
(866) 825-3227
Mailing address
161 WASHINGTON ST, EIGHT TOWER BRIDGE SUITE 1400, CONSHOHOCKEN, PA 19428-2083
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
054862
MO
Other
Enumeration date
10/30/2009
Last updated
10/30/2009
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