Individual
MRS. RHONDA SUE ELLERY-PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
801 JOE MANN BLVD, MIDLAND, MI 48642-8900
(989) 794-4032
(989) 354-4979
Mailing address
801 JOE MANN BLVD, MIDLAND, MI 48642-8900
(989) 794-4032
(989) 835-8710
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704177958
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704177958
STATE LICENSE NUMBER
MI
05
—
4975205
—
MI
01
—
500Z410370
BCBSM
MI
Enumeration date
11/17/2005
Last updated
10/26/2022
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