Provider Demographics
NPI:1871805127
Name:PEAVY, SPRING MEDLEY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SPRING
Middle Name:MEDLEY
Last Name:PEAVY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 E YORBA LINDA BLVD
Mailing Address - Street 2:NO. 485
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3327
Mailing Address - Country:US
Mailing Address - Phone:714-878-0570
Mailing Address - Fax:714-992-3169
Practice Address - Street 1:1040 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2111
Practice Address - Country:US
Practice Address - Phone:714-532-5353
Practice Address - Fax:714-532-5053
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19388363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily