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Individual

CAROL L PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1601 N TUCSON BLVD, STE 14, TUCSON, AZ 85716-3425
(520) 795-4155
Mailing address
3339 N BENTLEY AVE, TUCSON, AZ 85716-1206
(520) 628-7564

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP2811
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A0707220
NAT'L CERT NP
01
AP2811
NURSE PRACTR LICENSE
AZ
Enumeration date
10/01/2007
Last updated
10/01/2007
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