MARY ANN PEACOCK (NPI# 1679120893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679120893 |
| Entity Type | Individual |
| Full Name | MARY ANN PEACOCK |
| Credential | ARNP |
| Practice Address |
1012 Lucerne Ter Orlando FL 32806-1015 |
| Practice Telephone | 4074231039 |
| Practice Fax Number | 4074252347 |
| Mailing Telephone | 4074231039 |
| Mailing Fax Number | 4074252347 |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2019-12-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APRN11002892 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
11002892 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 104096400 | 05 |
| Street Address |
1012 LUCERNE TER |
| City | ORLANDO |
| State | FL |
| Zip Code | 32806-1015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295725562 | Cynthia R Waddell | Nurse Practitioner | 1012 Lucerne Ter, Orlando, FL 32806-1015 | 2005-10-26 |
| 1003440645 | Nafees Zehra Hussain | Nurse Practitioner | 1012 Lucerne Ter, Orlando, FL 32806-1015 | 2020-02-22 |
| 1831735711 | Timothy Joseph Anderson | Nurse Practitioner | 1012 Lucerne Ter, Orlando, FL 32806-1015 | 2019-11-26 |
| 1578914271 | Elijah Doron Obiero | Nurse Practitioner | 1012 Lucerne Ter, Orlando, FL 32806-1015 | 2016-06-24 |
| 1679998512 | Minh Quang Ho | Internal Medicine | 1012 Lucerne Ter, Orlando, FL 32806-1015 | 2014-03-02 |
| 1255615753 | Ashley Elizabeth Colman | Nurse Practitioner | 1012 Lucerne Ter, Orlando, FL 32806-1015 | 2011-10-03 |
| 1902197684 | Jarod Fox | Internal Medicine | 1012 Lucerne Ter, Orlando, FL 32806-1015 | 2011-04-28 |
| 1124322193 | Agustin Vega Santiago | Internal Medicine | 1012 Lucerne Ter, Orlando, FL 32806-1015 | 2011-01-05 |
| 1164750675 | Diana M. Salazar | Internal Medicine | 1012 Lucerne Ter, Orlando, FL 32806-1015 | 2009-11-20 |
| 1700110376 | Elina Bobkova | Internal Medicine | 1012 Lucerne Ter, Orlando, FL 32806-1015 | 2009-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710585674 | Erika Williams | Pharmacist | 2715 South Orlando Ave, Orlando, FL 32806 | 2020-10-13 |
| 1013545664 | Johanna Yadira Cook | Registered Nurse | Orlando Health Orlando Regional Medical Center, 52 W. Underwood St, Orlando, FL 32806 | 2020-03-30 |
| 1396372306 | Warren Andrew Williams | Student in an Organized Health Care Education/Training Program | 1222 S. Orange Ave., 5th Fl, Mp# 43, Orlando, FL 32806 | 2020-03-27 |
| 1225665433 | Astrid Helen Casin | Student in an Organized Health Care Education/Training Program | 1222 S. Orange Avenue, 5th Fl., Mp#43, Orland, FL 32806 | 2020-03-26 |
| 1508404211 | Hidden Potential Florida LLC | Assistant Behavior Analyst | 2857 South Bumby Avenue, Orlando, FL 32806 | 2019-12-12 |
| 1720639883 | Cynthia Lee Kling | Clinical Nurse Specialist | Arnold Palmer Hospital, 92 W. Miller St., Orlando, FL 32806 | 2019-09-20 |
| 1033769930 | Darleen Ann Williams | Clinical Nurse Specialist | 52 W. Underwood, Orlando, FL 32806 | 2019-09-13 |
| 1508412644 | Trischaday Kimberley Demetrius | Nurse Practitioner | Orlando Epilepsy Center, 226 W Michigan Street, Orlando, FL 32806 | 2019-08-14 |
| 1962964809 | Ajc Software Inc | Prosthetic/Orthotic Supplier | 1405 South Orange Avenue Suite 308, Orlando, FL 32806 | 2019-04-01 |
| 1598232852 | Sodo Smiles Dentistry, Pa | Dentist | 3123 S. Orange Ave., Suite 107, Orlando, FL 32806 | 2018-10-25 |
| Find all providers in zip 32806 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770100828 | Dana Santiago | Nurse Practitioner | 3110 Lake Jean Dr, Orlando, FL 32817-2324 | 2020-07-06 |
| 1609496629 | Autumn Nicole Walker | Nurse Practitioner | 2811 Ripton Ct, Orlando, FL 32835-6147 | 2020-04-20 |
| 1366913121 | Heather Freeman | Nurse Practitioner | 1400 S Orange Ave # Mp700, Orlando, FL 32806-2134 | 2018-12-05 |
| 1114403631 | Millian Okafor | Nurse Practitioner | 14918 Faberge Dr, Orlando, FL 32828-5118 | 2018-07-17 |
| 1134663933 | Marian Coppo Chase | Nurse Practitioner | 801 Vassar St, Orlando, FL 32804-4922 | 2016-12-13 |
| 1306291372 | Carlos Ivan Sanchez | Nurse Practitioner | 8012 Prestbury Dr, Orlando, FL 32832-6306 | 2016-04-27 |
| 1467831040 | Mary Philip | Nurse Practitioner | 13203 Chattanooga Ln, Orlando, FL 32837-4005 | 2015-05-28 |
| 1114325529 | Lola M Ortega | Nurse Practitioner | 1115 East Ridgewood Street, Orlando, FL 32803-6947 | 2014-12-17 |
| 1689090276 | Amina Hussain Ali | Nurse Practitioner | 6983 Brescia Way, Orlando, FL 32819-5269 | 2014-03-06 |
| 1447690870 | Rebecca Lee Ritz | Nurse Practitioner | 2111 Crosshair Cir, Orlando, FL 32837-7408 | 2013-06-30 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.