Doctor Name: | MRS. CASEY C PETERSON |
NPI Number: | 1609239938 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | RN214257 |
Business Practice Address: | 222 Perry Hwy Hawkinsville, GA - 310366748 |
Business Phone Number: | 4787830200 |
Business Fax Number: | |
Mailing Address: | 50 Oak Dr, HAWKINSVILLE |
State: | GA |
Postal Code: | 310366643 |
Phone Number: | 4782301388 |
Fax Number: | |
NPI Enumeration Date: | 04/04/2016 |
NPI Last Update Date: | 04/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN214257 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |