Provider Demographics
NPI:1174234769
Name:SCHARBERG CHAFFIN, PEGGY SUE (APRN)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:SUE
Last Name:SCHARBERG CHAFFIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 696
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:MT
Mailing Address - Zip Code:59829-0696
Mailing Address - Country:US
Mailing Address - Phone:406-544-1859
Mailing Address - Fax:
Practice Address - Street 1:2825 FORT MISSOULA RD STE 121
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-7403
Practice Address - Country:US
Practice Address - Phone:406-926-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-206056363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care