Individual
REBECCA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
297 MOUNTAIN VIEW EST, CARYVILLE, TN 37714-3539
(865) 382-2964
Mailing address
297 MOUNTAIN VIEW EST, CARYVILLE, TN 37714-3539
(865) 382-2964
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000088826
TN
Other
Enumeration date
05/17/2020
Last updated
05/17/2020
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