Provider Demographics
NPI:1386132082
Name:CONE, PEGGY SUE (LPN)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:SUE
Last Name:CONE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 GODLEY RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:GA
Mailing Address - Zip Code:31302-5063
Mailing Address - Country:US
Mailing Address - Phone:912-663-8505
Mailing Address - Fax:
Practice Address - Street 1:6707 FOREST PARK DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2566
Practice Address - Country:US
Practice Address - Phone:912-335-1699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)