Most Relevant Information
Provider Data
| NPI Number: | 1003268897 |
| Provider Name: | SANDRA L. PEACH APN |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209.014408 |
Most Important Dates
| Enumeration Date: | 07/06/2016 |
| Last Updated: | 06/28/2017 |
Provider Practice Location
420 NE GLEN OAK AVE
PEORIA
IL
616033105
Practice Location Phone/Fax
| Phone: | 3096552343 |
| Fax: | 3096553948 |
Provider Mailing Location
420 NE GLEN OAK AVE
PEORIA
IL
616033105
Provider Mailing Phone/Fax
| Phone: | 3096552343 |
| Fax: | 3096553948 |