Gallup, Peggy Grandy

Gallup, Peggy Grandy is an individual health care provider with primary practice located at 635 E Baseline Rd , Phoenix AZ 85042-6551. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Women's Health. Physician Assistants & Advanced Practice Nursing Providers / Women's Health is her primary health care specialty. Gallup, Peggy Grandy can be contacted via phone (602) 243-7277.

Contact Information

Primary practice address
635 E Baseline Rd Phoenix AZ 85042-6551
Phone: (602) 243-7277
Fax: (602) 243-1235
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN084459 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X A6793 Arizona

Profile Details

NPI number 1467425579
LBN Legal business name Gallup, Peggy Grandy
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Jul 2nd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467425579 NPPES
Arizona MEDICAID 000037

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