Provider Demographics
NPI:1073885851
Name:PEEK, GLOANNA (CPNP)
Entity Type:Individual
Prefix:
First Name:GLOANNA
Middle Name:
Last Name:PEEK
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 N MARTIN
Mailing Address - Street 2:PO BOX 210203
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-0203
Mailing Address - Country:US
Mailing Address - Phone:520-626-6327
Mailing Address - Fax:520-626-4062
Practice Address - Street 1:1305 N MARTIN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0203
Practice Address - Country:US
Practice Address - Phone:520-626-6327
Practice Address - Fax:520-626-4062
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN088430363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics