Provider Demographics
NPI:1619024882
Name:THOMAS, PEGGY BOYAR (ACNP-BC)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:BOYAR
Last Name:THOMAS
Suffix:
Gender:F
Credentials:ACNP-BC
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 240
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94573-0240
Mailing Address - Country:US
Mailing Address - Phone:707-303-5315
Mailing Address - Fax:707-963-4414
Practice Address - Street 1:ADVENTIST HEALTH ST HELENA
Practice Address - Street 2:10 WOODLAND RD
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574
Practice Address - Country:US
Practice Address - Phone:707-963-2002
Practice Address - Fax:707-963-2003
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP14443363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care