MRS. KIMBERLY DENISE PEGUES (NPI# 1073663167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073663167 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY DENISE PEGUES |
| Credential | FNP-C |
| Practice Address |
3869 Highway 81 Loganville GA 30052-3918 |
| Mailing Address |
1500 Wheat Grass Way Grayson GA 30017-4138 |
| Practice Telephone | 6786358650 |
| Mailing Telephone | 6783620570 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN127796 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2675 N Decatur Rd, 506, Decatur, GA 300336131 | 4042991679 |
| Street Address |
3869 HIGHWAY 81 |
| City | LOGANVILLE |
| State | GA |
| Zip Code | 30052-3918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770517674 | Kendra Vanice Gamble-webb | Obstetrics & Gynecology | 3869 Highway 81, Loganville, GA 30052-3918 | 2006-07-10 |
| 1487964896 | Drayer Physical Therapy Institute of Ky Pllc | Physical Therapist | 3869 Highway 81, Loganville, GA 30052-3918 | 2010-10-19 |
| 1194043844 | Stephanie Mary Tarracciano | Obstetrics & Gynecology | 3869 Highway 81, Loganville, GA 30052-3918 | 2010-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482397 | A Better Life Together, Inc | Day Training, Developmentally Disabled Services | 3343 Woodshade Drive, Loganville, GA 30052 | 2020-09-18 |
| 1184285025 | Felicia Maria Anderson | Counselor | 272 Fox Run, Loganville, GA 30052 | 2019-06-21 |
| 1225502768 | Jackie Kabahuma Zziwa | Registered Nurse | 4072 Atlanta High Way, Loganville, GA 30052 | 2019-01-17 |
| 1598243024 | Afolasade A Adeyemo | In Home Supportive Care | 154 Towler Shoals Dr, Loganville, GA 30052 | 2018-08-06 |
| 1831688654 | Julia Smith | Physician Assistant | 2745 Loganville Hwy, Loganville, GA 30052 | 2018-05-07 |
| 1306335534 | Emily Jannine Jamshedi | Physician Assistant | 3461 Skyland Ridge Ct, Loganville, GA 30052 | 2018-05-03 |
| 1346738655 | Laura Martha Avila | Nurse Practitioner | 221 The Esplanade Way Se, Loganville, GA 30052 | 2018-04-23 |
| 1942738901 | Local Dental Partners, LLC | Clinic/Center | 4353 Atlanta Highway Suite. 300, Loganville, GA 30052 | 2017-06-02 |
| 1649702804 | Cynthia Reeves | Counselor | 4160 Logan Drive, Loganville, GA 30052 | 2017-03-28 |
| 1689049330 | Samuel S Kwon - Loganville Dmd PC | Dentist | 2101 Baker Carter Drive, Suite 200, Loganville, GA 30052 | 2015-12-07 |
| Find all providers in zip 30052 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342309 | Melissa Lynn Scaparo | Nurse Practitioner | 3685 Anglin Rd, Loganville, GA 30052-4688 | 2020-10-02 |
| 1134733199 | Jesty Boby | Nurse Practitioner | 751 Autumn Meadow Dr, Loganville, GA 30052-7934 | 2020-09-07 |
| 1720617756 | Corwin Oswald Demattos | Nurse Practitioner | 4068 Elm Trace Dr, Loganville, GA 30052-5942 | 2020-04-02 |
| 1699306696 | Sonya Pedro | Nurse Practitioner | 3668 Park Hill Cir, Loganville, GA 30052-8408 | 2020-01-29 |
| 1003463365 | Katie Peper | Nurse Practitioner | E5139 Hillcrest Dr, Loganville, WI 53943-9719 | 2019-08-21 |
| 1487122065 | Tracey M Fortner | Nurse Practitioner | 1103 Mason Lee Ave, Loganville, GA 30052-8635 | 2018-11-13 |
| 1376021840 | Tessa Miche' Gerena-diaz | Nurse Practitioner | 1500 Holly Manor Dr, Loganville, GA 30052-5148 | 2018-08-06 |
| 1992293997 | Myrlande Cayo Taylor | Nurse Practitioner | 3838 Elm Trace Dr, Loganville, GA 30052-8769 | 2018-04-25 |
| 1346738655 | Laura Martha Avila | Nurse Practitioner | 221 The Esplanade Way Se, Loganville, GA 30052 | 2018-04-23 |
| 1386144376 | Nashana Powe | Nurse Practitioner | 961 Yancey Ct, Loganville, GA 30052-9092 | 2018-02-15 |
| Find all providers in LOGANVILLE | ||||
| City | LOGANVILLE |
| Zip Code | 30052 |
Please comment or provide details below to improve the information on MRS. KIMBERLY DENISE PEGUES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.