Provider Demographics
NPI:1558403345
Name:PEUGEOT, ALBERTA JANE (ARNP-C)
Entity Type:Individual
Prefix:
First Name:ALBERTA
Middle Name:JANE
Last Name:PEUGEOT
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:ALBERTA
Other - Middle Name:JANE
Other - Last Name:RUSPI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, MSN
Mailing Address - Street 1:19738 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2523
Mailing Address - Country:US
Mailing Address - Phone:301-766-7739
Mailing Address - Fax:301-766-7739
Practice Address - Street 1:426 WOODS STREET
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-1124
Practice Address - Country:US
Practice Address - Phone:301-846-1096
Practice Address - Fax:301-846-6150
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR170915363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health