Basic Information
| Provider Information | |||||||||
| NPI: | 1447574249 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PEEBLES | ||||||||
| FirstName: | VIRGINIA | ||||||||
| MiddleName: | MARGARITA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APN-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 131 SAUNDERSVILLE RD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370758903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158243737 | ||||||||
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| Practice Location | |||||||||
| Address1: | 176 BRIARWOOD AVE | ||||||||
| Address2: | SUITE B | ||||||||
| City: | CAMDEN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 38320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7315845144 | ||||||||
| FaxNumber: | 7315847477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2010 | ||||||||
| LastUpdateDate: | 07/28/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 14833 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 0192186 | 01 | TN | BCBSTN-GROUP | OTHER | 3719301 | 05 | TN | MEDICAID |