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NPI Code Detail

MEDICARE: PEGGY TYREE RN

MEDICARE: PEGGY TYREE RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN.261371OH

General Provider Information

NPI Number : 1629430723
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEGGY TYREE RN
Provider Business Mailing Address
First Line : 446 MORGAN ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45206-2348
Country : US
Telephone Number : 513-834-7937
Fax Number : 513-873-1567
Provider Business Practice Location Address
First Line : 4660 ROBERTS RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43228-9671
Country : US
Telephone Number : 513-834-7063
Fax Number : 513-873-1567
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2016
Last Update Date : 09/23/2019

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