Provider Demographics
NPI:1053374389
Name:LEVERETT, PEGGY LOUISE (ARNP)
Entity type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:LOUISE
Last Name:LEVERETT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:841 SYMPHONY ISLES BLVD
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2714
Mailing Address - Country:US
Mailing Address - Phone:813-641-0377
Mailing Address - Fax:813-903-4845
Practice Address - Street 1:13000 BRUCE B DOWNS BLVD
Practice Address - Street 2:RM 3A-318
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-972-2000
Practice Address - Fax:813-903-4845
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1924422363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner