DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: KELLY-ANN PETERS MS CCC-SLP, CLC

MEDICARE: KELLY-ANN PETERS MS CCC-SLP, CLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist528540MN

General Provider Information

NPI Number : 1336927334
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY-ANN PETERS MS CCC-SLP, CLC
Provider Business Mailing Address
First Line : 1689 FOREST LN SE
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-8929
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2017 NET WAY NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-5147
Country : US
Telephone Number : 218-333-6347
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2023
Last Update Date : 05/21/2026

Similar Medicare Providers

1427980408 — ALICIA POTTS
Practice Location Address:
2017 NET WAY NW
BEMIDJI, MN
56601-5147
Practice Phone: 218-333-5898
Practice Fax:
1821928029 — TESSA RICHARDSON
Practice Location Address:
2017 NET WAY NW
BEMIDJI, MN
56601-5147
Practice Phone: 218-333-4745
Practice Fax:
1134059397 — ELEANOR LEABCH
Practice Location Address:
2017 NET WAY NW
BEMIDJI, MN
56601-5147
Practice Phone: 218-333-6340
Practice Fax:
1164352993 — HALEY MERTENS
Practice Location Address:
2017 NET WAY NW
BEMIDJI, MN
56601-5147
Practice Phone: 218-333-5196
Practice Fax:
1508797051 — JEFFREY JAMES BREYEN
Practice Location Address:
2017 NET WAY NW
BEMIDJI, MN
56601-5147
Practice Phone: 218-333-6351
Practice Fax: 218-333-5766
1194656884 — ADAM BIRCH
Practice Location Address:
2017 NET WAY NW
BEMIDJI, MN
56601-5147
Practice Phone: 218-333-5926
Practice Fax:

Directions to “ KELLY-ANN PETERS MS CCC-SLP, CLC” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.