NINA E PEGRAM PNP - NPI 1548527344 - Nurse Practitioner in Ithaca, NY

Q: What is Nina Pegram's NPI number?

The NPI number for Nina Pegram is 1548527344. It was assigned to this individual provider in the NPPES registry on April 18, 2012.

Q: What is Nina Pegram's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Nina Pegram was last updated on May 6, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Nina E Pegram Pnp NPPES

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

NINA E PEGRAM PNP (NPI 1548527344) is an individual pediatrics provider in Ithaca, New York, licensed in New York (382280) and active in the NPI registry since April 2012.

NPPES Registry Identity

NPI1548527344

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameNINA E PEGRAMCredential: PNP

Location Address10 GRAHAM RD WIthaca, NY 14850-1055

Mailing Address10 Graham Rd WIthaca, NY 14850-1055 · (607) 257-2188 · Fax (607) 266-7341

Phone(607) 257-2188

Fax(607) 266-7341

Sole ProprietorNo

Enumeration DateApril 18, 2012

Last NPPES UpdateMay 6, 2020

NPPES CertifiedMay 6, 2020

✔ NPI 1548527344 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in NY · 382280

Also ListedLactation Consultant, Non-RNTaxonomy 174N00000X · License L-56399

10 GRAHAM RD W, Ithaca, NY 14850

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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.

CHARLENE BREW

Physician Assistant