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NPI Code Detail

MEDICARE: CECILIA PEASLEY CFNP

MEDICARE: CECILIA PEASLEY CFNP
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
1363L00000XNurse Practitioner4704134995MI

General Provider Information

NPI Number : 1164445524
Entity Type Code : Individual
Provider Name (Legal Business Name) : CECILIA PEASLEY CFNP
Provider Business Mailing Address
First Line : PO BOX 427
Second Line :
City : HILLMAN
State : MI
Zip : 49746-0427
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15774 STATE ST
Second Line :
City : HILLMAN
State : MI
Zip : 49746-7961
Country : US
Telephone Number : 989-742-4583
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 03/30/2020

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