Provider Demographics
NPI:1073550497
Name:PEACH, JOANNE (NP)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:PEACH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JOANNE
Other - Middle Name:H
Other - Last Name:HUTCHINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 SUNSET LN
Practice Address - Street 2:SUITE 2210
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3376
Practice Address - Country:US
Practice Address - Phone:540-825-6100
Practice Address - Fax:540-825-1829
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024040796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00130768OtherMEDICARE RAILROAD
VA010120659Medicaid
VAP00130768OtherMEDICARE RAILROAD
VA010120659Medicaid