PEGGY GRANDY GALLUP NP
NPI 1467425579
Nurse Practitioner - Women's Health in Phoenix, AZ

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LW0102X and a focus in Women's Health.

Active since February 09, 2006

635 E BASELINE RD, PHOENIX, AZ 85042(602) 243-7277(602) 243-1235 Get Directions Write a Review

NPPES record last updated: July 2, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Peggy Grandy Gallup Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEGGY GRANDY GALLUP NP (NPI 1467425579) is an individual women's health provider in Phoenix, Arizona, licensed in Arizona (A6793) and active in the NPI registry since February 2006.

NPPES Registry Identity

NPI1467425579

Entity TypeIndividualFemale

Primary Taxonomy363LW0102X

Provider Legal NamePEGGY GRANDY GALLUPCredential: NP

Location Address635 E BASELINE RDPhoenix, AZ 85042-6551

Mailing Address2702 North 3rd Street, Suite 4020Phoenix, AZ 85004-4608 · (602) 323-3345 · Fax (602) 323-3499

Phone(602) 243-7277

Fax(602) 243-1235

Sole ProprietorNo

Enumeration DateFebruary 9, 2006

Last NPPES UpdateJuly 2, 2015

✔ NPI 1467425579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LW0102X

License✔ Licensed in AZ · A6793

Also ListedNurse PractitionerTaxonomy 363L00000X · License RN084459 (AZ)

635 E BASELINE RD, Phoenix, AZ 85042

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Other Identifiers 6

Medicare PINZ145342AZ

Medicare UPINQ63228

Medicaid000037AZ

Medicare PIN108051

Medicare PINZ124128

Medicare PINZ155055AZ

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TOM KIRSCH LPC

Counselor