Provider Demographics
NPI:1093769846
Name:HEWLETT, PEGGY O'NEILL (RN,PHD)
Entity Type:Individual
Prefix:PROF
First Name:PEGGY
Middle Name:O'NEILL
Last Name:HEWLETT
Suffix:
Gender:F
Credentials:RN,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:15 MEDICAL PARK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-8003
Mailing Address - Country:US
Mailing Address - Phone:803-255-3417
Mailing Address - Fax:803-255-3451
Practice Address - Street 1:1400 GREENE STREET
Practice Address - Street 2:ROOM 303
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29208-0001
Practice Address - Country:US
Practice Address - Phone:803-777-5373
Practice Address - Fax:803-255-3451
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCR25292163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse