Individual
PENNIE DLAYNE PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
415 STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6034
(423) 975-2200
(423) 975-2210
Mailing address
105 TANASIE ST, ELIZABETHTON, TN 37643-6258
(423) 474-2499
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN0000100326
TN
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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