Basic Information
| Provider Information | |||||||||
| NPI: | 1497887426 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PEAK | ||||||||
| FirstName: | LORETTA | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | RNC,WHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4622 E SOUTH FORK DR | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850444970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6023615941 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4530 E RAY RD | ||||||||
| Address2: | 172 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850446094 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807599191 | ||||||||
| FaxNumber: | 4807599105 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | RN042975 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.