Peacock, Marianne

Peacock, Marianne is an individual health care provider with primary practice located at 1115 S Union St , Traverse City MI 49684-3258. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Peacock, Marianne can be contacted via phone (231) 935-0550.

Contact Information

Primary practice address
1115 S Union St Traverse City MI 49684-3258
Phone: (231) 935-0550
Fax: (231) 935-0551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704219432 Michigan

Profile Details

NPI number 1386631455
LBN Legal business name Peacock, Marianne
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2005
Last updated Aug 10th, 2009 - about 17 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 1386631455 NPPES
Michigan Other 08774010 BCBS OF MICHIGAN
Michigan Other 0B81224 BCBS OF MICHIGAN
Michigan Other 1386631455 BCBS OF MICHIGAN
Michigan Other 0P24620 BCBS OF MICHIGAN
Michigan Other 1245283365 BCBS OF MICHIGAN

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