Provider Demographics
NPI:1285062992
Name:ECKART, PEGGY
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:ECKART
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 1:205 BISHOPS WAY
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-6247
Mailing Address - Country:US
Mailing Address - Phone:262-207-9385
Mailing Address - Fax:
Practice Address - Street 1:205 BISHOPS WAY
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-6247
Practice Address - Country:US
Practice Address - Phone:262-207-9385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI61945-30163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control