Provider Demographics
NPI:1285689489
Name:PHALEN, PEGGY MURRAY (APRN)
Entity type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:MURRAY
Last Name:PHALEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 BLUEBIRD TRL
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:SC
Mailing Address - Zip Code:29477-6727
Mailing Address - Country:US
Mailing Address - Phone:843-563-3264
Mailing Address - Fax:
Practice Address - Street 1:219 S LEMACKS ST
Practice Address - Street 2:COLLETON COUNTY HEALTH DEPT
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-4371
Practice Address - Country:US
Practice Address - Phone:843-549-1516
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN 982363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner