Healthcare Provider Details

I. General information

NPI: 1962910877
Provider Name (Legal Business Name): PEGGY HOCUTT DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2018
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4611 E CHANDLER BLVD STE 112-1096
PHOENIX AZ
85048-0441
US

IV. Provider business mailing address

841 N OAK CT
CHANDLER AZ
85226-1852
US

V. Phone/Fax

Practice location:
  • Phone: 602-684-7719
  • Fax:
Mailing address:
  • Phone: 602-684-7719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP10629
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP10629
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP10629
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberAP10629
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: