Individual
LORI KAY PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
85 THOMAS JOHNSON CT, SUITE D, FREDERICK, MD 21702-4331
(301) 797-6389
(301) 797-4119
Mailing address
17 WESTERN MARYLAND PKWY, SUITE 100, HAGERSTOWN, MD 21740-5471
(301) 797-6389
(301) 797-4119
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN655903
PA
363L00000X
Nurse Practitioner
Primary
R127498
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072020800
—
MD
01
—
P01278432
RR MEDICARE
—
01
—
W2660035
BLUE SHIELD
MD
Enumeration date
08/01/2006
Last updated
05/28/2014
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