Individual
MRS. CAROL DIANE PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CDE
Contact information
Practice address
600 EAST BLVD, ELKHART, IN 46514-2483
(574) 523-3126
(574) 296-2920
Mailing address
58725 STELLA DR, ELKHART, IN 46517-9438
(574) 612-4870
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
21600264
IN
Other
Enumeration date
12/19/2019
Last updated
12/19/2019
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