JENNIFER J. PEACOCK (NPI# 1336513704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336513704 |
| Entity Type | Individual |
| Full Name | JENNIFER J. PEACOCK |
| Credential | DNP, APRN, NNP-BC |
| Practice Address |
2818 W 12875 S Riverton UT 84065-6837 |
| Mailing Address |
100 N Mario Capecchi Dr Salt Lake City UT 84113-1103 |
| Practice Telephone | 8012326595 |
| Mailing Telephone | 8016624100 |
| Mailing Fax Number | 8016624166 |
| Enumeration Date | 2015-11-22 |
| Last Update Date | 2015-11-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SN0000X |
Clinical Nurse Specialist Specialization: Neonatal |
289188-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275706814 | Jennifer April Peacock | Behavioral Analyst | 1557 Beaver Trail Dr, Cordova, TN 38016-6021 | 2008-04-03 |
| 1306349436 | Jennifer Peacock | Speech-Language Pathologist | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2018-03-15 |
| 1417340035 | Jennifer Peacock | Nurse Practitioner | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2015-03-06 |
| 1336482686 | Jennifer Nicole Peacock | Anesthesiology | 300 Community Dr, Manhasset, NY 11030-3876 | 2013-04-04 |
| Street Address |
2818 W 12875 S |
| City | RIVERTON |
| State | UT |
| Zip Code | 84065-6837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972248 | William Lance Andersen | Pharmacist | 1202 W 12600 W, Riverton, UT 84065 | 2020-11-02 |
| 1275172678 | Dentists of Riverton, LLP | Dentist | 4531 W. Partridgehill Lane, Suite F-110, Riverton, UT 84065 | 2020-01-02 |
| 1194201467 | Patrick Kunkel | Dentist | 12569 2700 W, #100, Riverton, UT 84065 | 2018-07-19 |
| 1790274546 | Harmon City Inc | Pharmacy | 13330 South Kestrel Range Road, Riverton, UT 84065 | 2018-05-08 |
| 1386147767 | Richard Hayes Johnston | Counselor | 3740 S Market Center Dr #1200, Riverton, UT 84065 | 2018-03-13 |
| 1023537156 | Brenda Fuell | Dental Hygienist | 12959 South Picket Fence Lane, Riverton, UT 84065 | 2017-09-09 |
| 1407373426 | Bethany Marie Breck | Counselor | 3740 S Market Center Drive, #1200, Riverton, UT 84065 | 2017-08-30 |
| 1952848509 | Renaissance Ranch Bluffdale Women's Program | Substance Abuse Rehabilitation Facility | 2356 Thunderhead Way, Bluffdale, UT 84065 | 2017-01-20 |
| 1053856229 | Bradford Scott Bentley Jr. | Physical Therapist | 3741 W 12600 S, Ste 100, Riverton, UT 84065 | 2016-12-27 |
| 1194273524 | New Horizon | Preferred Provider Organization | 1420 W 12600 Sputh, Draper, UT 84065 | 2016-09-14 |
| Find all providers in zip 84065 | ||||
| Taxonomy Code | 364SN0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Neonatal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770853558 | Kristin Kay Bradbury-kristensen | Clinical Nurse Specialist | 3302 S 300 W, Bountiful, UT 84010-7957 | 2012-01-10 |
| 1952694721 | Erika Jones | Clinical Nurse Specialist | 4113 Heatherfield Lane, Lehi, UT 84043 | 2011-05-26 |
| 1285927079 | Melanie Johnston Henderson | Clinical Nurse Specialist | 1034 N 500 W, Provo, UT 84604-3380 | 2011-05-26 |
| 1982738043 | Susan Joann Hall | Clinical Nurse Specialist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2007-03-14 |
Please comment or provide details below to improve the information on JENNIFER J. PEACOCK.
| 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.