Individual
MS. MARCIA KAY PETERZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1275 W GRANADA BLVD. STE 3A, COASTAL PEDIATRICS LLC, ORMOND BEACH, FL 32174
(386) 672-1490
(386) 672-1682
Mailing address
1275 W GRANADA BLVD STE 3A, COASTAL PEDIATRICS LLC, ORMOND BEACH, FL 32174
(386) 672-1490
(386) 672-1682
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN3136772
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ARNP3136772
STOFFL/DOH
FL
Enumeration date
11/14/2008
Last updated
01/07/2020
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