Provider Demographics
NPI:1689031411
Name:PEACOCK, CHRISTINA GARNER (FNP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:GARNER
Last Name:PEACOCK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:514 N BRIGHTLEAF BLVD STE 1610
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4486
Practice Address - Country:US
Practice Address - Phone:919-938-7187
Practice Address - Fax:919-938-7201
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5007866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily