Individual
ELLEN PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
912 W 21ST ST, CLOVIS, NM 88101-4149
(575) 935-9000
(575) 935-1002
Mailing address
912 W 21ST ST, CLOVIS, NM 88101-4149
(575) 935-9000
(575) 935-1002
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
74907
NM
Other
Enumeration date
08/04/2023
Last updated
08/04/2023
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