Provider Demographics
NPI:1376639179
Name:PEAK, GLORIA ANNE (FNP)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:ANNE
Last Name:PEAK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 401812
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92340-1812
Mailing Address - Country:US
Mailing Address - Phone:769-985-0771
Mailing Address - Fax:760-242-3033
Practice Address - Street 1:18077 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2197
Practice Address - Country:US
Practice Address - Phone:760-946-8799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP10745363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily