Provider Demographics
NPI:1780951707
Name:PEEBLES, HARMONI (PA)
Entity type:Individual
Prefix:
First Name:HARMONI
Middle Name:
Last Name:PEEBLES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E JEFFERSON ST
Mailing Address - Street 2:HOSPITALISTS OFFICE 4TH FLOOR
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-2219
Mailing Address - Country:US
Mailing Address - Phone:602-833-3199
Mailing Address - Fax:602-833-3190
Practice Address - Street 1:901 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-2219
Practice Address - Country:US
Practice Address - Phone:602-833-3199
Practice Address - Fax:602-833-3190
Is Sole Proprietor?:No
Enumeration Date:2011-11-18
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4982363A00000X
FLPA9106312363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ759119Medicaid
AZZ93264Medicare PIN