Provider Demographics
NPI:1912010026
Name:NOEL, PEGGY JEAN (ANP)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:JEAN
Last Name:NOEL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MS
Other - First Name:PEGGY
Other - Middle Name:JEAN
Other - Last Name:TROST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1017 ARROWWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-4801
Mailing Address - Country:US
Mailing Address - Phone:209-357-5513
Mailing Address - Fax:
Practice Address - Street 1:1017 ARROWWOOD LN
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-4801
Practice Address - Country:US
Practice Address - Phone:209-756-2132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA576323363LA2200X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health