NPI age
19 years
Enumerated 2007-01-31
● Active
Type 1 · Individual
Kimberly L Peacock, CRNA
Peacock is 1 of 19 nurse anesthetist, certified registered providers in Valdosta and 1 of 2157 in Georgia.
Primary specialty
Nurse Anesthetist, Certified Registered
Plus 1 subspecialty
Licensed in
MO, GA
2 states
Status
Active
No deactivations on record
Last NPPES update
2023-06-28
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 2157 active nurse anesthetist, certified registered providers in Georgia.
NPI age
19 years
↑ 4 yr above median (15 yr)
State licenses
2 states
Top 84% — 15% of peers are multi-state
Subspecialties
0
27% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-01Enumerated in NPPES
2007
2026
Where they practice
Practice location
4280 N Valdosta Rd
Valdosta, GA 316026814
Mailing address
Po Box 8846
Greensboro, NC 274190846
Specialties
-
Nurse Anesthetist, Certified Registered Primary(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (MO) | 175118 | MO BLUE SHIELD |
| 05 (MO) | 915080105 | |
| 01 (AR) | 98727 | ARK BLUE SHIELD |
| 05 (AR) | 141532701 | |
| 05 (GA) | 233419908B | |
| 05 (GA) | 233419908A | |
| 05 (GA) | 233419908C |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 22 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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