Provider Demographics
NPI:1477439230
Name:PECKINPAUGH, ANDREA (LM, CPM, BSM)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:PECKINPAUGH
Suffix:
Gender:F
Credentials:LM, CPM, BSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55279 BUCKHORN RD
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:MI
Mailing Address - Zip Code:49093-9651
Mailing Address - Country:US
Mailing Address - Phone:269-929-7032
Mailing Address - Fax:
Practice Address - Street 1:16050 WAYNE ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MI
Practice Address - Zip Code:49130-9637
Practice Address - Country:US
Practice Address - Phone:574-248-2485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7601000156176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife