SANDRA M PEACOCK (NPI# 1780909036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780909036 |
| Entity Type | Individual |
| Full Name | SANDRA M PEACOCK |
| Credential | APRN |
| Practice Address |
423 Cypress St Sulphur LA 70663-4964 |
| Practice Telephone | 3375287992 |
| Practice Fax Number | 3375287994 |
| Mailing Telephone | 3375287992 |
| Mailing Fax Number | 3375287994 |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2010-03-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
AP02623 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629457148 | Sandra Peacock | Genetic Counselor, MS | 2450 Holcombe Blvd, Houston, TX 77021-2039 | 2015-05-29 |
| Street Address |
423 CYPRESS ST |
| City | SULPHUR |
| State | LA |
| Zip Code | 70663-4964 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457822751 | Imperial Calcasieu Human Services Authority | Clinic/Center | 2651 E Napoleon St, Sulphur, LA 70663 | 2018-12-12 |
| 1083134670 | Leah Lowe | Nurse Practitioner | 1019 Mathew St., Sulphur, LA 70663 | 2017-06-23 |
| 1972037166 | Collins Orthopaedics LLC | Orthopaedic Surgery | 250 S Beglis Parkway, Ste 3, Sulphur, LA 70663 | 2017-04-14 |
| 1699219238 | Charles Miah Smith | Family Medicine | 231 W Houston River Rd., Sulphur, LA 70663 | 2016-12-16 |
| 1598213357 | Fresenius Medical Care Sulphur, LLC | Clinic/Center | 1000 Beglis Pkwy, Sulphur, LA 70663 | 2016-09-21 |
| 1992129019 | Healthscripts of America-southwest Louisiana,llc | Pharmacy | 1575 Maplewood Drive, Suite A, Sulphur, LA 70663 | 2014-02-10 |
| 1679900476 | Evergreen Presbyterian Ministries, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2108 Division Street, Sulphur, LA 70663 | 2013-10-11 |
| 1295065241 | Journey Behavioral Health, LLC | Psychologist | 423 Cypress St., Sulphur, LA 70663 | 2010-01-13 |
| 1558513754 | C H Wilkinson Physician Network | Nurse Practitioner | 525 North City Service Hwy, Sulphur, LA 70663 | 2008-10-21 |
| 1689853343 | Stelly Physical &occupational Therapy | Occupational Therapist | 946 Beglis Parkway, Sulphur, LA 70663 | 2007-10-30 |
| Find all providers in zip 70663 | ||||
| Taxonomy Code | 364SP0809X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609248376 | Declouet Psychiatric Services, LLC | Clinical Nurse Specialist | 100 Billeaud Ln, Lafayette, LA 70506-3108 | 2015-10-21 |
| 1811000540 | Sandra R Williams | Clinical Nurse Specialist | 2495 Shreveport Hwy 71 North, Pineville, LA 71360 | 2006-08-16 |
| 1881843571 | Caron C. Slusser Aprn, LLC | Clinical Nurse Specialist | 208 Highland Park Plz, Suite 208, Covington, LA 70433-7129 | 2008-09-17 |
| 1811144744 | Caron Slusser | Clinical Nurse Specialist | 208 Highland Park Plz, Suite 208, Covington, LA 70433-7129 | 2008-08-21 |
Please comment or provide details below to improve the information on SANDRA M 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.