Provider Demographics
NPI:1215332473
Name:PEGHER, NICOLE CISNEROS
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:CISNEROS
Last Name:PEGHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 COUNTRY WAY
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-2408
Mailing Address - Country:US
Mailing Address - Phone:781-812-9445
Mailing Address - Fax:781-787-2416
Practice Address - Street 1:164 WASHINGTON ST STE 104
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061
Practice Address - Country:US
Practice Address - Phone:781-812-9445
Practice Address - Fax:781-787-2416
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife