Individual
ER'REAL ROSE MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
12470 TELECOM DR STE 100, TEMPLE TERRACE, FL 33637-0904
(813) 779-6303
(888) 977-1998
Mailing address
4320 COMMONS DR W UNIT 4102, DESTIN, FL 32541-8655
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
APRN11003381
FL
363L00000X
Nurse Practitioner
APRN11003381
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11003381
FL
Other
Enumeration date
10/21/2019
Last updated
11/03/2020
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