Individual
NORA PEGUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 GLASSCO ST, CLEVELAND, MS 38732-4434
(662) 843-4150
Mailing address
PO BOX 1681, CLEVELAND, MS 38732-1681
(662) 843-4150
(662) 843-3401
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770576
—
MS
Enumeration date
03/02/2023
Last updated
03/02/2023
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