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Individual

PETER MATTHEW VAN DALEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
204 SHORESIDE DR, LEXINGTON, KY 40515-5606
(919) 592-0101
Mailing address
204 SHORESIDE DR, LEXINGTON, KY 40515-5606
(919) 592-0101

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
255054
NC

Other

Enumeration date
02/10/2022
Last updated
04/20/2026
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