Individual
DEBORAH K PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9131 COLLEGE POINTE CT, FORT MYERS, FL 33919-3245
(239) 343-9100
(239) 343-9108
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9100
(239) 343-9108
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
71000238A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11013139
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000650200
ANTHEM
IN
01
—
000000659437
ANTHEM
IN
05
—
111708600
—
FL
05
—
200956040
—
IN
01
—
P00971563
RR MEDICARE
IN
Enumeration date
07/27/2006
Last updated
11/10/2021
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