MEDICARE: ANDREA PECKINPAUGH LM, CPM, BSM

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
1	176B00000X	Midwife	7601000156	MI

General Provider Information

NPI Number	:	1477439230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA PECKINPAUGH LM, CPM, BSM

Provider Business Mailing Address
First Line	:	55279 BUCKHORN RD
Second Line	:
City	:	THREE RIVERS
State	:	MI
Zip	:	49093-9651
Country	:	US
Telephone Number	:	269-929-7032
Fax Number	:

Provider Business Practice Location Address
First Line	:	16050 WAYNE ST
Second Line	:
City	:	UNION
State	:	MI
Zip	:	49130-9637
Country	:	US
Telephone Number	:	574-248-2485
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2025
Last Update Date	:	08/15/2025

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