National Provider Identifier
Nina E Pegram, PNP
Nina E Pegram, PNP is listed in the NPPES registry with a primary specialty of Pediatric Nurse Practitioner in Ithaca, NY and a listed phone number of (607) 257-2188.
Profile Overview
- NPI
- 1548527344
- Provider Type
- Individual
- Primary Specialty
- Pediatric Nurse Practitioner
- Enumeration Date
- April 18, 2012
- Last Updated
- May 06, 2020
Practice Location
- 10 Graham RD W
- Ithaca, NY 14850-1055
Phone: (607) 257-2188
Specialties
- Pediatric Nurse Practitioner (363LP0200X)
- Lactation Consultant (Non-RN) (174N00000X)
Full Record
- NPI
- 1548527344
- Entity Type
- Individual
- Last Name
- Pegram
- First Name
- Nina
- Middle Name
- E
- Credential
- PNP
- Mailing Street Address
- 10 Graham RD W
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1055
- Mailing Country
- US
- Mailing Phone
- (607) 257-2188
- Mailing Fax
- (607) 266-7341
- Practice Street Address
- 10 Graham RD W
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1055
- Practice Country
- US
- Practice Phone
- (607) 257-2188
- Practice Fax
- (607) 266-7341
- Enumeration Date
- April 18, 2012
- Last Updated
- May 06, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- May 06, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatric Nurse Practitioner (363LP0200X), Lactation Consultant (Non-RN) (174N00000X)