Healthcare Provider Details

I. General information

NPI: 1902987670
Provider Name (Legal Business Name): PEGGY SAXTON R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 03/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 10TH ST
WORTHINGTON MN
56187-2343
US

IV. Provider business mailing address

508 10TH ST
WORTHINGTON MN
56187-2343
US

V. Phone/Fax

Practice location:
  • Phone: 507-372-2921
  • Fax: 507-372-5789
Mailing address:
  • Phone: 507-372-2921
  • Fax: 507-372-5789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: