Organization
HEART TO HEART PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINNY M PETER CPNP (NURSE PRACTITIONER)
(618) 939-0112
Entity
Organization
Contact information
Practice address
224 BRADFORD LN, WATERLOO, IL 62298-3369
(618) 939-0112
Mailing address
224 BRADFORD LN, WATERLOO, IL 62298-3369
(618) 939-0112
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/10/2019
Last updated
10/02/2019
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