Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 7697 | KS |
Y | 207VE0102X | Reproductive Endocrinologist | 32136 | OK |
NPI | 1609162163 |
---|---|
Provider Name | Jamie Peregrine |
First Address | Oklahoma City, OK 73104-5036 |
Second Address | Oklahoma City, OK 73104-5036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2011 |
Last Update Date | 08/01/2019 |