Peacock, Hannah Marie

Peacock, Hannah Marie is an individual health care provider with primary practice located at 2212 N Broadway St , Moore OK 73160-4303. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Peacock, Hannah Marie can be contacted via phone (405) 285-7222.

Contact Information

Primary practice address
2212 N Broadway St Moore OK 73160-4303
Phone: (405) 285-7222
Fax: (405) 285-7227
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3211 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 3211 Oklahoma

Profile Details

NPI number 1770106619
LBN Legal business name Peacock, Hannah Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2020
Last updated Aug 27th, 2026 - about 2 months 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 1770106619 NPPES
Oklahoma Other 14670040 CAQH
Oklahoma MEDICAID 200913150A CAQH

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