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Individual
KELLEY J PETERS
Active
Individual
KELLEY J PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28145162A
IN
363L00000X
Nurse Practitioner
71005210A
IN
363L00000X
Nurse Practitioner
COA16762
OH
363LF0000X
Family Nurse Practitioner
Primary
25358
TN
Other
Enumeration date
10/20/2014
Last updated
11/08/2023
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