Individual
ALLISON V PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
482 S LIBERTY DR, BLOOMINGTON, IN 47403-1927
(812) 353-3443
(812) 353-3442
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004541A
IN
363A00000X
Physician Assistant
8610
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099274
—
AZ
Enumeration date
06/23/2020
Last updated
09/24/2024
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