Mickey Peasley, R.N.

Individual provider Active NPI Registered Nurse · Muscoda, WI

NPI 1205280237 · NPPES record last updated Apr 15, 2016

Key facts

NPI
1205280237
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
135964-30 (WI)
Practice address
298 N 7TH St
Trailer # 9
Muscoda, WI 53573-9211
Phone
(608) 604-7890
NPI assigned
Apr 15, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
135964-30WIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 135964-30 WI Yes

Addresses

Primary practice location

298 N 7TH St
Trailer # 9
Muscoda, WI 53573-9211

Mailing address

PO Box 676
Muscoda, WI 53573-0676
Phone (608) 604-7890

Other providers in Muscoda, WI

All providers in Muscoda, WI · Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.