Individual
THEWANDA ANISE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2525 COURT DR, GASTONIA, NC 28054-2140
(704) 834-4113
Mailing address
1550 UNION RD STE B, GASTONIA, NC 28054-5522
(704) 864-8772
(704) 866-7853
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
088356
NC
Other
Enumeration date
07/11/2011
Last updated
11/15/2024
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