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General NPI Number Information
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NPI Number | 1124148879
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Entity Type | Organization
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Legal Business Name | PEGGY J BAIR, RNFA, LLC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 2304 N KACHINA CT
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City | CHANDLER
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State | AZ
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Zip | 85224-2284
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Country | US
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Telephone | 480-390-2436
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Fax |
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Provider Business Mailing Address
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Address Line | 2304 N KACHINA CT
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City | CHANDLER
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State | AZ
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Zip | 85224-2284
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RNFA
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Name | PEGGY JO BAIR
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Credential |
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Telephone | 480-390-2436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | RN107405
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP2795
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License Number State | AZ
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