Doctor Name: | EVIE TESCH PETERS |
NPI Number: | 1356763197 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 18692 |
Business Practice Address: | 1202 Palm Blvd Isle Of Palms, SC - 294512296 |
Business Phone Number: | 8438864402 |
Business Fax Number: | |
Mailing Address: | 3003 Treadwell St, MOUNT PLEASANT |
State: | SC |
Postal Code: | 294669257 |
Phone Number: | 4045432199 |
Fax Number: | |
NPI Enumeration Date: | 01/14/2014 |
NPI Last Update Date: | 03/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 18692 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |