Individual
MS. GILDA H. PEGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
3333 S CRATER RD, ., PETERSBURG, VA 23805-9276
(804) 862-9253
Mailing address
PO BOX 4153, PETERSBURG, VA 23803-0153
(804) 862-9253
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
0015000306
VA
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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