Provider Demographics
NPI:1114647708
Name:CHIPKIN, PEGGY SCHWARTZ (RN, NP, FNP)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:SCHWARTZ
Last Name:CHIPKIN
Suffix:
Gender:F
Credentials:RN, NP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 E BLITHEDALE AVE STE F
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2060
Mailing Address - Country:US
Mailing Address - Phone:415-389-8589
Mailing Address - Fax:
Practice Address - Street 1:158 E BLITHEDALE AVE STE F
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2060
Practice Address - Country:US
Practice Address - Phone:415-389-8589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA223224363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner