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Individual

KELCEY PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2621 GARDEN KNOLL LN, RALEIGH, NC 27614-8971
(919) 723-8789
Mailing address
2621 GARDEN KNOLL LN, RALEIGH, NC 27614-8971
(919) 723-8789

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
374U00000X
NC

Other

Enumeration date
08/07/2013
Last updated
08/07/2013
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