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Individual

DANIEL STUART PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4013 BEATLINE RD STE A, LONG BEACH, MS 39560-4135
(228) 200-0720
Mailing address
4013 BEATLINE RD STE A, LONG BEACH, MS 39560-4135
(228) 200-0720

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R894559
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
906031
MS

Other

Enumeration date
10/04/2022
Last updated
04/03/2025
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