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Individual

PEGGY BIRKENFELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
300 W HALSELL ST, DIMMITT, TX 79027-1846
(806) 647-8780
(806) 647-3769
Mailing address
300 W HALSELL ST, DIMMITT, TX 79027-1846
(806) 647-8780
(806) 647-3769

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
241316
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00N49A
BCBS
TX
05
063566601
TX
05
063566602
TX
05
146595002
TX
01
458679
GROUP MEDICARE
TX
Enumeration date
04/25/2006
Last updated
01/29/2014
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