Individual
NICOLE R PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1236 HUFFMAN MILL RD, SUITE 2000, BURLINGTON, NC 27215-8700
(336) 585-1770
Mailing address
3100 SPRING FOREST RD, SUITE130, RALEIGH, NC 27616-2880
(919) 873-9533
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
227618
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
NA-10544
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145590044
TRICARE
NC
05
—
1457590044
—
NC
Enumeration date
02/05/2009
Last updated
03/04/2014
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