Doctor Name: | MRS. ANGELA SUE PETERS |
NPI Number: | 1407132897 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NURSE PRACTITIONER A |
License Number: | 4674-33 |
Business Practice Address: | 2520 Elisha Ave Zion, IL - 600992676 |
Business Phone Number: | 8478724561 |
Business Fax Number: | |
Mailing Address: | 2520 Elisha Ave, ZION |
State: | IL |
Postal Code: | 600992676 |
Phone Number: | 8478724561 |
Fax Number: | |
NPI Enumeration Date: | 10/29/2011 |
NPI Last Update Date: | 12/20/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 4674-33 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |