Individual
MS. AMANDA D PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5509 BUCHANAN ST, MERRILLVILLE, IN 46410-1918
(847) 418-0739
Mailing address
5509 BUCHANAN ST, MERRILLVILLE, IN 46410-1918
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043100307
IL
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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