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Organization

PHASES OF HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GLORIA V PETERS NP (OWNER)
(985) 781-2462
Entity
Organization

Contact information

Practice address
161 PEBBLE BEACH DR, SLIDELL, LA 70458-5746
(985) 781-2462
(985) 202-8180
Mailing address
161 PEBBLE BEACH DR, SLIDELL, LA 70458-5746
(985) 781-2462

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1972844769
NPPES
Enumeration date
03/24/2023
Last updated
05/30/2023
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